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頁籤選單縮合
題名 | 頭部創傷後抗利尿激素不適當分泌症候群--病例報告=Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) in a Patient with Head Injury--A Case Report |
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作者 | 黃暘凱; 楊榮武; 官文雄; 顏欽堉; 張敏德; Huang, Yang-kai; Yang, Rong-wu; Guan, Wen-hsiung; Yen, Ching-yu; Chang, Min-te; |
期刊 | 臺灣口腔顎面外科學會雜誌 |
出版日期 | 20120300 |
卷期 | 23:1 2012.03[民101.03] |
頁次 | 頁33-44 |
分類號 | 415.597 |
語文 | chi |
關鍵詞 | 頭部創傷; 低血鈉; 抗利尿激素不適當分泌症候群; Head injury; Hyponatremia; Syndrome of inappropriate antidiuretic hormone secretion; SIADH; |
中文摘要 | 於頭部創傷及顱額外傷之病患中,低血鈉為一常見之電解質異常,而造成此異常之可能原因主要為抗利尿激素不是當分泌症候群、腦下垂體功能低下及大腦耗鹽症候群,其中抗利尿激素不適當分泌症候群為最常見之因素. 抗利尿激素不適當分泌症候群臨床診斷標準為1)低張性低血鈉2)尿液滲透壓大於血液滲透壓3)尿鈉排泄增加4)等量肢體液及5)正常腎臟、腎上腺及甲狀腺之功能.臨床症狀主要為低血鈉之表現,輕微者可能會有頭痛、肌肉無力、噁心、嘔吐之症狀,而較嚴重的低血鈉則可能造成困倦、癲癇發作、昏迷乃至於死亡.其治療方式則為低血鈉之矯治,包括限制水分、食鹽水輸注及藥物治療.本報告知病例為一21歲男性,因車禍導致頭部創傷及下顎骨骨折,術後進而發生抗利尿激素不適當分泌症候群之患者,經手術、水分限制及高張食鹽水輸注治療後恢復良好,無復發情形或相關臨床症狀.由於臨床診治頭部創傷及顱顏外傷時,須注意抗利尿激素不適當分泌症候群發生之可能,因此提出此病例,並做相關文獻之回顧與討論. |
英文摘要 | Hyponatremia is a common electrolyte abnormality in patients with head injury and facial trauma. The causes of hyponatremia have been reported as syndrome of inappropriate antidiuretic hormone secretion (SIADH) , hypopituitarism, and cerebral salt wasting syndrome (CSWS). SIADH is the main cause of hyponatremia in patients with head injury. SIADH is characterized by the following cardinal diagnostic criteria: 1) hypotonic hyponatremia, 2) urine osmolality in excess of plasma osmolality, 3) increased renal sodium excretion, 4) clinical euvolemia, and 5) normal renal, adrenal, and thyroid function. The clinical features of SIADH are mainly those of hyponatremia. Mild hyponatremia induces headache, muscle weakness, nausea, and vomiting, while severe hyponatremia causes drowsy, seizures, coma, and even death. The treatment options of SIADH are essentially those to correct hyponatremia, including water restriction, saline infusion, and medications. In this case, the 21 years old gentleman suffered from head injury and mandibular fracture due to a motorcycle accident, and developed SIADH. After surgical intervention, water restriction and hypertonic saline infusion, he recovered well and there were no recurrence or relative symptoms and signs. Hyponatremia due to SIADH after head injury and facial trauma frequently occurs; therefore, we reviewed the literatures for SIADH. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。