ICU内高钠血症病因及治疗的临床评价

周璐

[摘要] 目的 分析重症监护病房（ICU）内患者发生高钠血症的原因，并探讨高钠血症的治疗方法及其治疗效果。 方法 于2014年1月～2017年1月期间，选取我院ICU收治的200例危重患者进行回顾性研究，根据患者在ICU内是否发生高钠血症，将患者分为高钠血症组、无高钠血症组，比较两组ICU患者的临床资料，对导致ICU患者发生高钠血症的危险因素进行单因素分析、多因素Logistics线性回归分析。对高钠血症患者的临床治疗方法进行总结，对其转归情况进行观察。 结果 200例ICU患者中，共有42例患者发生高钠血症，高钠血症发生率为21.00%。经单因素分析、多因素Logistics线性回归分析后明确，血容量不足、钠离子输入过多、APACHE II评分过高是导致ICU患者发生高钠血症的危险因素。转归情况方面，经治疗后，高钠血症患者的APACHE II评分均明显降低（P<0.05），其血钠水平也明显降低（P<0.05），且其各项生命体征均可见明显改善（P<0.05）。 结论 ICU患者容易受到血容量、钠离子输入、APACHE II评分等因素的影响而发生高钠血症，临床上应针对患者的原发病及其病因进行对症治疗，以纠正血钠紊乱，改善生命体征。

[关键词] 重症监护病房；高钠血症；病因；危险因素

[中图分类号] R459.7 [文献标识码] A [文章编号] 2095-0616（2017）15-242-03

[Abstract] Objective To analyze the causes of hypernatremia in patients with intensive care unit （ICU）， and to explore the treatment methods and effects of hypernatremia. Methods From January 2014 to January 2017，200 cases of critically ill patients of ICU in our hospital were selected and studied retrospectively， according to the ICU patients whether or not had hypernatremia，the patients were divided into hypernatremia group and non hypernatremia group.The clinical data were compared between two groups of patients with ICU，leading to the the risk factors of ICU patients with hypernatremia were analyzed by univariate analysis and multivariate Logistics regression analysis.The clinical treatment methods of hypernatremia patients were summarized，and the prognosis was observed. Results In the 200 patients with ICU， there was 42 cases of hypernatremia patients，and the incidence of hypernatremia was 21%.After single factor analysis and multivariate Logistics linear regression analysis，it is clear that the lack of blood volume，excessive input of sodium ions and excessive APACHE and II score are the risk factors for hypernatremia in ICU patients.After the treatment，the APACHE II scores of the hypernatremia patients was significantly lower （P<0.05），and the blood sodium levels was significantly lower（P<0.05），and all the vital signs were obviously improved（P<0.05）. Conclusion ICU patients are easily affected by the blood volume，sodium ion input and APACHE II score factors and hypernatremia，clinicians should be symptomatic treatment for primary disease and etiology of patients，in order to correct the blood sodium disorders，improve the signs of life.

[Key words] Intensive care unit；Hypernatremia；Etiology；Risk factors

重癥监护病房（intensive care unit，ICU）收治的患者主要为危重症患者，其病情凶险，致死风险较高，尤其是伴发水电解质紊乱的患者[1]。高钠血症属于常见水电解质紊乱[2]，容易加重病情，故应对其发生原因进行明确，再施以针对性治疗，以纠正其血钠水平。本研究主要是通过对2014年1月～2017年1月期间我院ICU收治的200例危重患者进行回顾性研究，根据其是否发生高钠血症进行分组和比较，进一步分析重症监护病房内患者发生高钠血症的原因，并对高钠血症的治疗方法及其治疗效果进行探讨，现报道如下。

1 资料与方……