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首页> 外文期刊>The Open Anesthesia Journal >LETTER TO THE EDITOR-Attempted Control of Serum Sodium Concentration During Liver Transplantationin Severely Hyponatraemic Patients
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LETTER TO THE EDITOR-Attempted Control of Serum Sodium Concentration During Liver Transplantationin Severely Hyponatraemic Patients

机译：致严重低钠血症患者肝移植过程中血清钠浓度的编辑尝试尝试控制

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Hyponatraemia (serum sodium <135 mmol/L) is very common in patients with end stage liver disease. Between 1993 and 2005, 32.4% of all liver recipients demonstrated a serum sodium concentration <134 mmol-L (10.5% <130 mmol-L) across the UK and Ireland [1]. Peri-operative [Na] is an important and reliable indicator of severity of illness as patients demonstrate a higher calculated MELD? (22.3+/- 9.3). A MELD-Na score which can be as much as 13 points higher has also been proposed [2]. Hyponatraemia is also a good predictor of waiting list mortality, longer surgical times, higher intra-operative transfusion requirements, poor post-operative outcomes and reduced 90 day survival - 84% versus 95% [1-4]. Major morbidity includes sepsis and multi-organ failure (64.2%), neurological problems (10-30%) and graft failure (8.6%) [1]. Central pontine myelinolysis (CPM) is the most serious neurological sequela and tends to develop up to the 11th post-operative day [1, 4-6]. It is caused by the osmotic demyelination of neurons as intraoperative serum sodium concentration and osmolality change rapidly [7,8]. Symptoms include lethargy, seizure, coma, permanent brain damage, brainstem herniation, respiratory arrest and death [4].
机译：低钠血症（血清钠<135 mmol / L）在晚期肝病患者中非常普遍。在1993年至2005年之间，英国和爱尔兰的所有肝脏接受者中32.4％的血清钠浓度<134 mmol-L（10.5％<130 mmol-L）[1]。围手术期[Na]是疾病严重程度的重要且可靠的指标，因为患者表现出更高的MELD？ （22.3 +/- 9.3）。还提出了MELD-Na评分，最高可提高13分[2]。低钠血症也是等待名单死亡率，更长的手术时间，更高的术中输血量，术后不良预后和90天生存率下降的良好预测指标-84％比95％[1-4]。主要发病率包括败血症和多器官衰竭（64.2％），神经系统疾病（10-30％）和移植物衰竭（8.6％）[1]。桥脑中枢髓鞘溶解（CPM）是最严重的神经系统后遗症，并且倾向于发展到术后第11天[1，4-6]。它是由于术中血清钠浓度和重量摩尔渗透压浓度迅速变化而引起的神经元渗透性脱髓鞘作用引起的[7,8]。症状包括嗜睡，癫痫发作，昏迷，永久性脑损伤，脑干突出，呼吸停止和死亡[4]。

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