目的:探讨颅脑损伤后脑耗盐综合征患者的诊断与治疗策略。方法:对我科2006~2007年收治的37例CSWS患者临床资料进行回顾性分析和总结。结果:经治疗,37例CSWS患者31例血钠恢复正常,4例死亡,无1例发生桥脑髓鞘溶解症。结论:脑耗盐综合征是颅脑损伤后患者低钠血症的最主要原因。早期明确诊断,积极稳妥补液补钠是有效治疗CSWS患者的关键。
【摘要】 目的 探讨开颅手术夹闭颅内前循环动脉瘤破裂的方法和疗效。 方法 回顾分析2005年1月-2008年1月28例前循环动脉瘤破裂的早期外科手术治疗情况。分析其临床表现、手术入路和预后，用格拉斯哥术后评分量表对术后患者神经功能评分。 结果 28例患者共30个动脉瘤，手术成功夹闭28个，包裹2个。术后3个月内，患者恢复良好15例（53.57%），中度病残7例（25.00%），重度病残5例（17.86%），死亡1例（3.57%）。 结论 早期开颅手术夹闭动脉瘤能减少再出血率和术前死亡率，术后预后较好，是治疗前循环动脉瘤破裂较为理想的方法。【Abstract】 Objective To investigate the clinical strategy and effect of early phase surgery for ruptured cerebral anterior circulating aneurysm. Methods A retrospective analysis was done for 28 patients with ruptured anterior circulating aneurysms who underwent early phase (within 3 days) surgical clipping from January 2005 to January 2008. Their manifestations, surgical approach, and outcomes were analyzed. Glasgow outcome scale (GOS) was used to evaluate patients’ neurological function after operation. Results Among 30 intracranial aneurysms in 28 patients, 28 aneurysms were clipped successfully, and the other 2 were wrapped. One patient (3.57%) died after surgery. The follow-up data showed an excellent outcome was achieved in 15 cases, mild disability in 7 cases, and severe disability in 5 cases. Conclusion Early phase surgical clipping for ruptured cerebral anterior circulating aneurysm can reduce the chance of reruputure of aneurysms and the mortality in preoperative phase with good outcomes. The early phase surgical clipping the aneurysms is considered the feasible opinion.