gogo收稿日期:2023-01-17;修回日期:2023-03-15,,,爭(zhēng)論方向?yàn)槟X血管病及顱內(nèi)腫:,,,,,:腦血管病和顱內(nèi)腫瘤的顯微外科治療。56n北京大學(xué)人民醫(yī)院神經(jīng)外科,北京100044,,202356,,:;;;,50%[1-6],[6],,(osmoticdemyelinatingsyndrome,ODS[6,7],2023,(syndromeant-idiuretichormone,SIADH(cerebralsaltwasting,CSW[8],1,19502023PubMedCochraneSIADHCSW,Walters[9]。,/L,[10],,130mmol/L131mmol/L(II[8]。,測(cè),鈉(III類(lèi),(III131mmol/L,(ex-tracellularfluid,ECF(>285mOs/kg高血(血<285mOs/kgECF:1((如CS;>200mOs/kg<25mmol/L>25mmol/Lo,(tnghormone,TSH(freethyroxine,FT4,SIADH(>100mOs/kg>25mOs/kg(TSHFT4((<100mOs/kg。?,,[8]。4CSWSIADHCSWSIADH,病CSW,[11]SIADH鈉,,,[12],CSWSIADH,,靜(1。1CSWSIADH的診斷與鑒別診斷CSWSIADH,mmol/L*<135<135,mOsm/kg*<285<285,mOsm/kg*>200>200,mmol/L>25>25|{液體平衡|{+血尿素氮{|{|||2O<6>6,mmHg<8>8355.1(CentralpontinemyelinolysisODS[7,13],ODS>48(,12mmol/L/d,ODS[14]>1mmol/L/h(/(<48[8]。5.2SIADHSIADH,,,SIADH:SAHSIADH/66mmol/L182mmol/L,248mmol/L131mmol/L,SIADH(1。1SIADH(HHH,hypervolemia,hypertension,hemodilution;5.3CSWCSW,SAHCSW/66mmol/L,66mmol/L182mmol/L,248mmol/L,131mmol/L后,(subarachnoidhemorrhage,SAH131~135mmol/L[8],(2。2CSW6結(jié)論,,其[15]131mmol/L,,TSHFT4,(CVP(PCWPCSWSIADH(III;8~10mmol/L/d(III;CSW;SAH,有SAH(I;SAHH/(III參考文獻(xiàn)[1]UpadhyayA,JaberBL,MadiasNE.Incidenceandpreva-lenceofhyponatremia.AmJMed.2023,119(7Suppl:S30-35.[2]SherlockM,O”SullivanE,AghaA,etal.Incidenceandpathophysiologyofseverehyponatraemiainneurosurgicalpa-tients.PostgradMedJ,2023,85(1002:171-175.[3]KristofRA,RotherM,NeulohG,etal.Incidence,clinicalmanifestations,andcourseofwaterandelectrolytemetabolismdisturbancesfollowingtranssphenoidalpituitaryadenomasurgery:aprospectiveobservationalstudy.JNeurosurg,2023,111(3:555-562.[4]BedersonJB,ConnollyESJr,BatjerHH,etal.Guidelinesforthemanagementofaneurysmalsubarachnoidhemorrhage:astatementforhealthcareprofessionalsfromaspecialwritinggroupoftheStrokeCouncil,AmericanHeartAssociation.Stroke.2023,40(3:994-1025.[5]Donati-GenetPC,DubuisJM,GirardinE,etal.Acutesymptomatichyponatremiaandcerebralsaltwastingafterheadinjury:animportantclinicalentity.JPediatrSurg,2023,36(7:1094-1197.[6]FraserJF,StiegPE.Hyponatremiaintheneurosurgicalpa-tient:epidemiology,pathophysiology,diagnosis,andmanage-ment.Neurosurgery,2023,59(2:222-229;discussion222-229.TsutsumiS,YasumotoY,ItoM.Centralpontineandextrap-ontinemyelinolysisinaninfantassociatedwiththetreatmentofcraniopharyngioma:casereport.NeurolMedChir,2023,48(8:351-354.RahmanM,FriedmanWA.Hyponatremiainneurosurgicalpa-tients:clinicalguidelinesdevelopment.Neurosurgery.2023,65(5:925-935.BeanJR.NeurosurgeryinTransition:TheSocioeconomicTrans-formationofNeurologicalSurgery(ConceptsinNeurosurgery.1ed,Lexington:Williams&Wilkins,1998.99-111.JanicicN,VerbalisJG.Evaluationandmanagementofhypo-osmolalityinhospitalizedpatients.EndocrinolMetabClinNAm,2023,32(2:459-481.[11]SternsRH,SilverSM.CerebralsaltwastingversusSIADH:whatdifference?JAmSocNephrol,2023,19(2:194-196.[12]Cerd-EsteveM,Cuadrado-GodiaE,ChillaronJJ,etal.Cerebralsaltwastingsyndrome:review.EurJInternMed,2023,19(4:249-254.KawaharaI,TokunagaY,IshizakaS,etal.Reversibleclin-icalandmagneticresonanceimagingofcentralpontinemyel-inolysisfollowingsurgeryforcraniopharyngioma:serialmagneticresonanceimagingstudies.NeurolMedChir,2023,9(3:120-123.LohrJW.Osmoticdemyelinationsyndromefollowingcorrectionofhyponatremia:associationwithhypokalemia.AmJMed,1994,96(5:408-413.,,.(128.,2023,36(1:5-8.收稿日期:2023-01-24;修回日期:2023-03-22,,,主要從事顱腦腫瘤的微創(chuàng)外科爭(zhēng)論。NSE在顱腦損傷中的臨床意義山西省人民醫(yī)院神經(jīng)外科,山西太原030012,,NSENSENSE:;神經(jīng)元;,,,(GCS(G