Abstract
ObjectiveTo explore the etiology and diagnosis and treatment strategy of traumatic brain injury complicated with hyponatremia.Methods90 patients with traumatic brain injury admitted to our hospital from December 2019 to December 2020 were retrospectively analyzed and divided into hyponatremic group (50 patients) and non-hyponatremic group (40 patients) according to the patients' concomitant hyponatremia, and the clinical data of the two groups were collected and compared. In addition, patients in the hyponatremia group were divided into a control group and an experimental group of 25 patients each according to their order of admission, with the control group receiving conventional treatment and the experimental group using continuous renal replacement therapy (CRRT). Hemodynamic indices, mortality and serum neuron-specific enolase (NSE) indices before and after treatment were compared between the control and experimental groups. The Glasgow coma scale (GCS) was used to assess the degree of coma before and after the treatment in the two groups, and the patients' disease status was assessed using the Acute Physiological and Chronic Health Evaluation Scoring System (APACHE II).ResultsThe etiology of traumatic brain injury complicated with hyponatremia is related to the degree of brain injury, ventricular hemorrhage, cerebral edema, and skull base fracture (P < 0.05). After the treatment, the hemodynamic indexes, APACHE II scores, death rate, and NSE levels of the experimental group were significantly lower than those of the control group (P < 0.001); The experimental group yielded remarkably higher GAC scores as compared to the control group (P < 0.001).ConclusionThe degree of brain injury, ventricular hemorrhage, cerebral edema, and skull base fracture were considered to be the main factors for traumatic brain injury complicated with hyponatremia. Continuous renal replacement therapy can effectively improve the clinical indicators of the patients with a promising curative effect, which merits promotion and application.
Highlights
Traumatic brain injury, as a common disease in neurosurgery, refers to the organic damage to the brain tissue caused by severe head trauma [1, 2], with a rather high disability rate and fatality rate
Patients in the hyponatremia group were divided into a control group and an experimental group of 25 patients each according to their order of admission, with the control group receiving conventional treatment and the experimental group using continuous renal replacement therapy
The etiology of patients with complicated hyponatremia had no correlation with past medical history, mannitol application, and concussion (P > 0.05), while it was correlated with the degree of craniocerebral injury, intraventricular hemorrhage, cerebral edema, and skull base fracture (P < 0.05)
Summary
As a common disease in neurosurgery, refers to the organic damage to the brain tissue caused by severe head trauma [1, 2], with a rather high disability rate and fatality rate. Patients with traumatic brain injury are frequently complicated with hyponatremia, which may trigger neurological dysfunction or even death and disability in severe cases due to damages to the patients’ nerve cells. Continuous renal replacement therapy (CRRT) refers to a group of therapeutic techniques for extracorporeal blood purification, which are widely used in the treatment of critically ill patients with various non-renal diseases [13]. It has the advantages of continuous, slow, isotonic and high-volume solute exchange, hemodynamic stability, removal of medium-molecular substances such as inflammatory mediators, and continuous and stable control of electrolyte and acid-base balance [14].
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