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低血症的诊断和治疗:一篇综述
Horacio J Adrogué1,2, Bryan M Tucker1,2, Nicolaos E Madias3,4
1Section of Nephrology, Department of Medicine, Baylor College of Medicine, Houston, Texas.
JAMA
|July 19, 2022
概括
低血症是一种常见的电解质疾病,影响5%的成年人,增加了住院和死亡率. 治疗包括解决根本原因,在严重病例中使用特定疗法,以防止透性脱髓化等危险并发症.
科学领域:
- 肝脏病学
- 内部医学
- 内分泌学
背景情况:
- 低血是最常见的电解质疾病,影响5%的成年人和35%的住院患者.
- 定义为血清< 135mEq/ L,通常是由于水分保留而导致的,并且与住院时间和死亡率的增加有关.
- 症状从轻微 (虚弱) 到严重 (发作,昏迷),取决于发病速度,持续时间和严重程度.
研究的目的:
- 审查低血的临床意义,症状和治疗策略.
- 强调低血与认知障碍,跌倒,骨折和骨质疏松症的相关性.
- 概述低血症的治疗指南,包括针对特定疾病和紧急情况的治疗方法.
主要方法:
- 关于低血量患病率,症状和临床结果的文献综述
- 对低血与跌倒,骨折和骨密度相关的研究分析.
- 检查当前的治疗指南和治疗选择,包括尿素,vaptans和高血压盐水.
主要成果:
- 轻度慢性低血与认知障碍,步态障碍,跌倒和骨折有关.
- 低血症被认为是骨质疏松症的次要原因.
- 治疗策略取决于液体体积状况 (低血压,高血压,高血压) 和症状严重程度.
结论:
- 大多数低血症病例需要治疗潜在疾病.
- 尿素和瓦普坦是不适当的抗尿素综合征和与心力衰竭相关的低血症的选择,具有潜在的副作用.
- 严重症状的低血症需要紧急用高血溶液治疗,并仔细监测以避免透性脱髓化.
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