目的 探讨肝硬化合并低钠血症的发病特点及临床治疗策略。方法 统计130例肝硬化合并低钠血症患者的临床表现及并发症,分析 Child-Pugh分级与低钠血症程度的关系,根据不同的低钠水平给予相应浓度的氯化钠治疗,观察治疗后转归。结果 不同肝功能分级的血钠浓度差异有统计学意义(P<0.05),肝功能C级患者血钠浓度[(109.2±4.2) mmol/L]显著低于肝功能A级[(130.8±5.6) mmol/L]和B级[(127.3±6.1) mmol/L](P<0.05)。不同血钠浓度分级的治疗效果差异有统计学意义(P<0.05),轻度低钠血症患者治疗效果较好。结论 低钠血症对于肝硬化患者的预后有着重要的影响,应根据患者不同血钠浓度给予针对性的处理。

Objective To investigate the pathogenesis and the clinical treatment strategy of hyponatremia in patients with liver cirrhosis, in order to improve the quality of life in patients with liver cirrhosis hyponatremia, reduce lethality and provide valuable reference. Methods 130 patients with liver cirrhosis in this hospital from January 2010 to January 2012 were complicated by hyponatremia. The clinical manifestations and complications of patients were recorded to analyze the relationship between Child-Pugh classification and the degree of hyponatremia. Patients were treated with different concentrations of sodium chloride according to different low sodium levels. Prognosis was observed after treatment. Results 15 cases had hepatic encephalopathy, 7 cases had hemorrhage of upper digestive tract, 7 cases had hepatorenal syndrome ( HRS ), and 10 patients had hypokalemia. There were statistically significant differences in serum sodium concentration in different liver function classification (P<0.05). Further comparison showed that the liver function of patients with C level of the serum sodium concentration was significantly lower. After the treatment, no patients with serum sodium concentration 131-135 mmol/L had died, while in the patients with serum sodium concentration of 121-130 mmol/L and <120 mmol/L ,7 died. There were significant differences between different grades of liver function and therapeutic effect in the patients (P<0.05), and patients with serum sodium concentration of 131-135 mmol/L had significantly better effect. Conclusions Liver cirrhosis complicated by hyponatremia has an important impact on the prognosis of patients, and should be given specific treatment according to patients, different blood concentration of sodium.