Buonocore C M, Robinson A G
Department of Medicine, University of Pittsburgh School of Medicine, Pennsylvania.
Endocrinol Metab Clin North Am. 1993 Jun;22(2):411-23.
The abrupt presentation of hypertonic polyuria, polydipsia and hypernatremia, reflects vasopressin deficiency owing to multiple potential etiologies. Diabetes insipidus becomes an emergency and leads to severe hyperosmolality and dehydration when fluid intake does not match obligate losses. Decreased mental alertness may impair the ability to sense thirst or to obtain access to fluids, thus placing patients postoperatively or posttrauma at particular risk of complicated diabetes insipidus. Intravenously administered DDAVP and hydration with hypotonic fluids is the preferred therapy in the acute setting. As diabetes insipidus may be of unpredictable duration, the need for ongoing medical therapy must be frequently reassessed.
高渗性多尿、烦渴和高钠血症的突然出现，反映了由于多种潜在病因导致的血管加压素缺乏。当液体摄入量与 obligate losses 不匹配时，尿崩症会成为紧急情况并导致严重的高渗状态和脱水。精神警觉性降低可能会损害感知口渴或获取液体的能力，从而使术后或创伤后的患者特别容易发生复杂性尿崩症。在急性情况下，静脉注射去氨加压素和用低渗液体进行补液是首选治疗方法。由于尿崩症的持续时间可能无法预测，因此必须经常重新评估持续药物治疗的必要性。
