Dunn K, Butt W
Intensive Care Unit, Royal Children's Hospital, Parkville, Victoria, Australia.
J Paediatr Child Health. 1997 Feb;33(1):26-30. doi: 10.1111/j.1440-1754.1997.tb00986.x.
To determine the aetiology, symptoms and outcome of extreme sodium derangement in a paediatric inpatient population.
A retrospective study of children with extreme disturbance of their plasma sodium (> or = 165 mmol/L or < or = 115 mmol/L) admitted to a tertiary referral centre during a 72-month period.
Twenty-seven cases of hypernatraemia and 21 of hyponatraemia were reviewed. Sodium disturbance developed after hospital admission in 27/57 cases (57%). Gastroenteritis was the most common cause of hypernatraemia (8/27; 30%), four of 27 (15%) had iatrogenic hypernatraemia. Water overload accounted for 8/21 (38%) cases of hyponatraemia. Neurologic symptoms occurred in 19/24 (79%) with hypernatraemia and in 11/19 (58%) with hyponatraemia. Ten (37%) with hypernatraemia and four (19%) with hyponatraemia died. A deterioration in functional status was seen in two patients with hypernatraemia. There was no apparent deterioration in the survivors with hyponatraemia.
Extreme sodium disturbance often develops after admission to hospital and is caused by a variety of diseases and interventions. Neurologic symptoms are common and the mortality rate is high. The outcome in survivors is survivors is most likely to be dependent on the underlying disease process.
确定儿科住院患者中极端钠紊乱的病因、症状及转归。
对一家三级转诊中心在72个月期间收治的血浆钠极度紊乱（≥165 mmol/L或≤115 mmol/L）的儿童进行回顾性研究。
回顾了27例高钠血症和21例低钠血症病例。57例中有27例（57%）在入院后出现钠紊乱。胃肠炎是高钠血症最常见的病因（8/27；30%），27例中有4例（15%）为医源性高钠血症。水负荷过重占低钠血症病例的8/21（38%）。高钠血症患者中19/24（79%）出现神经症状，低钠血症患者中11/19（58%）出现神经症状。高钠血症患者中有10例（37%）死亡，低钠血症患者中有4例（19%）死亡。2例高钠血症患者的功能状态恶化。低钠血症幸存者无明显功能恶化。
极端钠紊乱常在入院后发生，由多种疾病和干预措施引起。神经症状常见，死亡率高。幸存者的转归很可能取决于基础疾病进程。
