Vieweg W V
Department of Psychiatry, Medical College of Virginia, Virginia Commonwealth University, Richmond.
J Clin Psychiatry. 1994 Apr;55(4):154-60.
The clinician must first identify the patient at risk of developing water intoxication and its complications including seizures, coma, and death. In the polydipsic patient, behavioral approaches correcting or limiting polydipsia may prevent progression to dilutional hyponatremia. Drugs that oppose the central release or renal action of antidiuretic hormone will usually normalize morning serum sodium concentration in patients with the polydipsia-hyponatremia syndrome. The clinician can monitor such patients by observing diurnal changes in body weight. Specific interventions derive from specific weight changes. For the symptomatic patient suffering from water intoxication, intravenous administration of saline raising the serum sodium concentration to the 120-mmol/L range, followed by fluid restriction to further correct hyponatremia, will almost always successfully correct hyponatremia and protect against central pontine myelinolysis.
临床医生必须首先识别有发生水中毒及其并发症（包括癫痫发作、昏迷和死亡）风险的患者。对于烦渴多饮的患者，纠正或限制烦渴多饮的行为方法可能会防止病情发展为稀释性低钠血症。对抗抗利尿激素中枢释放或肾脏作用的药物通常会使烦渴多饮-低钠血症综合征患者的早晨血清钠浓度恢复正常。临床医生可以通过观察体重的昼夜变化来监测此类患者。具体的干预措施取决于特定的体重变化。对于有水中毒症状的患者，静脉输注生理盐水使血清钠浓度升至120 mmol/L范围，随后限制液体摄入以进一步纠正低钠血症，几乎总能成功纠正低钠血症并预防中枢性桥脑脱髓鞘病变。
