论文部分内容阅读
目的分析24例小儿重型病毒性脑炎时血清电解质(钠、钾、钙、镁)的浓度改变及其临床意义。方法所有病例入院后立即采静脉血测定血清钠、钾、钙、镁的浓度,并于治疗后第3天及1周后复查。结果入院时发现低钠血症14例,高钠血症2例,低钾血症8例,低钙血症合并低镁血症4例。治疗3d后复查低钠血症纠正,仍有高钠血症2例,严重低钾血症1例,低钙合并低镁血症1例,其中高钠血症2例及严重低钾血症1例均死亡,除死亡病例外1周后复查血清电解质均恢复正常。结论小儿重型病毒性脑炎时血清电解质紊乱是一严重合并症,可能与脑炎时病理生理改变和治疗中大剂量应用脱水剂有关。本组资料显示发生高钠血症和严重低钾血症是病情危重的信号,低钙和低镁血症可诱发或加重惊厥。
Objective To analyze the changes of serum electrolytes (sodium, potassium, calcium and magnesium) in 24 children with severe viral encephalitis and their clinical significance. Methods Venous blood samples were collected for determination of serum sodium, potassium, calcium and magnesium concentrations immediately after admission and were reviewed on day 3 and week 1 after treatment. Results 14 cases of hyponatremia, 2 cases of hypernatremia, 8 cases of hypokalemia, 4 cases of hypocalcemia with hypomagnesemia were found on admission. After 3 days of treatment, re-examination of hyponatremia was still performed. There were still 2 cases of hypernatremia, 1 case of severe hypokalemia, 1 case of hypocalcemia with hypomagnesemia, 2 cases of hypernatremia and severe hypokalemia One patient died, and the serum electrolytes returned to normal after one week except death. Conclusions Serum electrolyte imbalance in children with severe viral encephalitis is a serious complication, which may be related to the pathophysiological changes of encephalitis and the application of large doses of dehydrating agent in the treatment. This group of data show that hypernatremia and severe hypokalemia is a critically ill signal, hypocalcemia and hypomagnesemia can induce or aggravate convulsions.