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电解质紊乱与原发性脑干出血患者意识障碍转归的相关性分析
Correlation of disturbance of electrolyte balance with outcome of disorders of consciousness in patients with primary brainstem hemorrhage
- 第三军医大学学报 2021年43卷第15期 页码：1424-1429
- 作者机构：
1.400037 重庆，陆军军医大学(第三军医大学)第二附属医院: 疼痛与康复医学科
2.400037 重庆，陆军军医大学(第三军医大学)第二附属医院: 放射科
3.400038 重庆，陆军军医大学(第三军医大学)基础医学院生理学教研室，脑与智能研究院
- 作者简介：
[刘勇，E-mail：lzsht@aliyun.com LIU Yong, E-mail: lzsht@aliyun.com
[姚忠祥，E-mail: yaozhx@yahoo.com YAO Zhongxiang, E-mail: yaozhx@yahoo.com
- 基金信息：国家自然科学基金创新研究群体项目(31921003)
DOI：10.16016/j.1000-5404.202102102
中图分类号： R363.13;R743.34;R749.13收稿：2021-02-21，
修回：2021-06-04，
纸质出版：2021-08-15
- 稿件说明：
移动端阅览
孙娟, 左诗怡, 陈珍珍, 等. 电解质紊乱与原发性脑干出血患者意识障碍转归的相关性分析[J]. 第三军医大学学报, 2021,43(15):1424-1429.
Juan SUN, Shiyi ZUO, Zhenzhen CHEN, et al. Correlation of disturbance of electrolyte balance with outcome of disorders of consciousness in patients with primary brainstem hemorrhage[J]. Journal of Third Military Medical University, 2021, 43(15): 1424-1429.
孙娟, 左诗怡, 陈珍珍, 等. 电解质紊乱与原发性脑干出血患者意识障碍转归的相关性分析[J]. 第三军医大学学报, 2021,43(15):1424-1429. DOI： 10.16016/j.1000-5404.202102102.
Juan SUN, Shiyi ZUO, Zhenzhen CHEN, et al. Correlation of disturbance of electrolyte balance with outcome of disorders of consciousness in patients with primary brainstem hemorrhage[J]. Journal of Third Military Medical University, 2021, 43(15): 1424-1429. DOI： 10.16016/j.1000-5404.202102102.
摘要
目的
2
探讨患者原发性脑干出血后电解质紊乱的特点及其与意识障碍转归的相关性。
方法
2
从陆军军医大学第二附属医院2010年1月1日至2020年9月1日收治的350例脑干出血患者中筛选出原发性脑干出血并进行标准化补液病例47例，根据意识状态分为无意识障碍组(
n
=21)、意识障碍组(
n
=21)和意识障碍转清醒组(
n
=5)，收集全病程静脉血钠离子、钾离子、氯离子、阴离子间隙(AG)和二氧化碳(CO
2
)含量的检测结果，分析其均值、最大值、最小值、异常率、平均波动幅度等指标的变化规律和特点，并探讨其与意识障碍患者转归的关系。
结果
2
单因素方差分析进行组间比较发现，在无意识障碍组、意识障碍组和意识障碍转清醒组之间，氯离子、阴离子间隙的均值、最大值、最小值、异常率和平均波动幅度差异均具有统计学意义(
P
<
0.05)；而钠离子、钾离子和CO
2
含量在上述3组之间，除CO
2
含量的异常率和平均波动幅度之外，差异均无统计学意义。进一步进行组内多重比较分析发现，与无意识障碍组比较，氯离子和阴离子间隙在意识障碍组的均值、最大值、异常率和平均波动幅度均显著升高，而最小值显著降低(
P
<
0.01)；钾离子、阴离子间隙、CO
2
含量在意识障碍转清醒组的异常率和平均波动幅度均显著升高(
P
<
0.01)，而钠离子和氯离子的差异均无统计学意义。
结论
2
电解质紊乱与原发性脑干出血的意识障碍程度密切相关，尤其是氯离子和阴离子间隙的异常率和平均波动幅度越高，意识障碍就越严重。
Abstract
Objective
2
To investigate the characteristics of disturbance of electrolyte balance after primary brainstem hemorrhage (PBH) and their correlation with the outcome of patients with disorders of consciousness (DOC).
Methods
2
A retrospective survey was used to statistically analyze the clinical data of 350 patients with brainstem hemorrhage admitted to the Second Affiliated Hospital of Army Military Medical University from January 1
2010 to September 1
2020. With our strict inclusion and exclusion criteria
47 PBH cases undergoing standardized fluid replacement were screened out. Then they were divided into the non-DOC group (
n
=21)
DOC group (
n
=21) and DOC translating to non-DOC group (
n
=5) according to their state of consciousness. The quantities of venous blood electrolyte and carbon dioxide during the whole duration of hospital stay were collected
and then analyzed for the changes of sodium
potassium
chloride
anion gap (AG) and CO
2
. Next
we analyzed the rule and characteristics of the changes of mean value
maximum value
minimum value
abnormal rate
average fluctuation range and other indicators
and explored their relationship with PBH.
Results
2
One-way analysis of variance (ANOVA) showed that there were significant differences in the mean value
maximum value
minimum value
abnormal rate and average fluctuation range of chloride ion and AG among the 3 groups (
P
<
0.05). But in addition to the abnormal rate and average fluctuation range of CO
2
content
there were no statistical differences in the contents of sodium ion
potassium ion and CO
2
among the 3 groups. Further multiple intra-group comparative analysis indicated that the mean value
maximum value
abnormal rate and average fluctuation range of chloride ion and AG were signi
ficantly increased
while the minimum value was decreased in the DOC group than the non-DOC group (
P
<
0.01). The abnormal rate and average fluctuation range of potassium ion
AG and CO
2
content were significantly increased (
P
<
0.01)
but no statistical significance was seen in sodium and chloride in the DOC translating to non-DOC group than the non-DOC group.
Conclusion
2
The disturbance of electrolyte balance is closely associated with the DOC severity in PBH patients. The higher the abnormal rate of chloride ion and AG and the average fluctuation range are
the more severe DOC is.
关键词
Keywords
references
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