某三级医院急性脑卒中患者血清电解质状况分析

Mymensingh medical journal : MMJ Pub Date : 2023-04-01
B Khan, M Moniruzzaman, M R Karim, F Ahamed, R Pervin, M A Rahman, M A Hosen
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引用次数: 0

摘要

中风通常是局灶性而非全局性神经功能缺损,由血管起源引起,并伴有脑梗死或脑出血。它在血管损伤和电解质失衡后导致脑水肿。2016年3月至2018年5月,在孟加拉国Mymensingh医学院医院医学系进行了一项描述性横断面研究,目的是评估220例经CT扫描确诊的脑卒中患者的电解质水平。数据由主要研究者本人在征得同意后,采用访谈时间表和病例记录表收集。采集患者血样,进行生化和血液学测试,并评估血清电解质水平。对数据的完整性、一致性和相关性进行交叉检查,并采用SPSS 20.0软件进行分析。出血性卒中患者的年龄(64.88±13.00岁)明显高于缺血性卒中患者(60.92±13.96岁)。男性占55.91%,女性占44.09%;缺血性脑卒中119例(54.09%),出血性脑卒中101例(45.91%)。测定脑卒中急性期血清Na+、K+、Cl-、HCO₃-的浓度。血清钠、氯、钾、碳酸氢盐失衡的比例分别为37.27%、29.55%、23.18%和6.36%。低钠血症、低钾血症、低氯血症和酸中毒是缺血性和出血性中风中最常见的电解质失衡。缺血性卒中低钠血症占35.29%,高钠血症占3.36%,低钾血症占19.33%,高钾血症占0.84%,低氯血症占30.25%,高氯血症占3.36%,酸中毒占6.72%,碱中毒占1.68%。出血性卒中低钠血症占33.66%,高钠血症占1.98%,低氯血症占22.77%,高氯血症占3.96%,低氯血症占19.80%,高氯血症占4.95%,酸中毒占2.97%,碱中毒占0.99%。低钠血症、低钾血症和低氯血症患者的死亡率更高。
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Serum Electrolyte Status of Patients with Acute Stroke Admitted in a Tertiary Care Hospital.

Stroke, usually a focal rather than global neurological deficit resulting from vascular origin with sudden onset, may be with cerebral infarction or intracerebral haemorrhage. It results in brain oedema following vascular injury and electrolyte imbalance. A descriptive cross sectional study was carried out in the Department of Medicine, Mymensingh Medical College Hospital, Mymensingh, Bangladesh during March 2016 to May 2018 to assess the electrolyte levels among 220 purposively selected patients with stroke confirmed by CT scan. Data were collected by the principal investigator himself by using interview schedule and case record form after attaining consent. Blood samples were collected from the patients to carry out biochemical and haematological tests and to assess serum electrolyte levels. Data were cross-checked for completeness, consistency and relevancy, and were analyzed by computer software SPSS 20.0. Age was significantly higher in haemorrhagic stroke (64.88±13.00 years) than ischaemic stroke (60.92±13.96 years). Male (55.91%) were predominant than female (44.09%). One hundred nineteen (54.09%) patients had ischaemic stroke and 101(45.91%) patients had haemorrhagic stroke. The serum concentration of Na+, K+, Cl- and HCO₃- were measured during acute period of stroke. Imbalance in serum Sodium, Chloride, Potassium and Bicarbonate level were observed in 37.27%, 29.55%, 23.18% and 6.36% patients respectively. Hyponatremia, hypokalemia, hypochloremia and acidosis were most common electrolyte imbalance in both ischaemic and haemorrhagic strokes. In ischaemic stroke hyponatremia was 35.29%, hypernatremia was 3.36%, hypokalemia 19.33%, hyperkalemia 0.84%, hypochloraemia 30.25%, hyperchloraemia 3.36%, acidosis was in 6.72% and alkalosdis in 1.68% patients while in haemorrhagic stroke hyponatremia 33.66%, hypernatremia 1.98%, hypokalaemia 22.77% hyperkalemia 3.96%, hypochloremia 19.80%, hyperchloraemia 4.95%, acidosis 2.97% and alkalosis was in 0.99% of patients. Mortality was more in hyponatremic, hypokalemic and in hypochloremic patients.

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