嚴重低血鈉(血鈉 < 120 mmol/L伴隨中樞神經係統症狀如譫妄、嗜睡甚至昏迷)的傳統治療,是靜脈滴注高濃度(3%)生理鹽水,幾個小時內把血鈉升高幾個mmol,然後再緩慢升高血鈉,同時糾正病因。糾正過快,導致腦細胞脫水,造成脫髓鞘綜合征。輕者行為障礙,重者昏迷甚至死亡。
遇到這種病人,下醫囑輸3% 生理鹽水,總是提心吊膽。有一次下醫囑3% 生理鹽水4小時,輸液到晚上11點結束。早晨在計算機上查病人,發現病人還在輸。護士的記錄說:問值班醫生,值班醫生要求一直輸。嚇了一跳。趕快給ICU 打電話。接電話的護士說,她剛剛停掉。這個護士比值班的醫生還懂。
一次和同事聊天。同事說uptodate推薦, 在輸3%生理鹽水的同時,靜脈注射DDAVP(抗利尿激素),促使腎髒吸收水分,從而減緩血鈉升高的速度。我說,這是一個荒唐的主意。擔心血鈉升高過快,降低輸液速度就行了,為什麽要多此一舉。同事回答uptodate 有臨床研究證據支持。
這麽一說,我決定查一查。
首先是uptodate 的文章: Overview of the treatment of hyponatremia in adults. 作者Richard H Sterns, MD。 文章建議對於低血鈉原因可以很快糾正,或者容易發生滲透性脫髓鞘綜合征的病人,在靜脈滴注3%生理鹽水 1 ml/kg 的同時,給與DDAVP (Desmopressin) 以預防低血鈉糾正過快。文章引用兩個實驗證據。
證據一[1]2014年發表在美國腎髒協會臨床雜誌上。研究共有20個ICU病人,血鈉<120 mmol/L。試驗給病人輸3%生理鹽水,比較給與DDAVP前後血鈉上升幅度。用DDAVP 後,血鈉上升速度比用DDAVP前減慢 0.02 mmol/L/hour。![](data:image/png;base64,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)
證據二[2]2013年發表在美國腎髒雜誌上, 標題是:Hypertonic saline and desmopressin: a simple strategy for safe correction of severe hyponatremia。研究者之一是上麵uptodate 文章的作者。 Simple strategy 改為redundant strategy 更合適。研究隻有25個病人,血鈉低於120 mmol/L。 給與3% 生理鹽水的同時給與DDAVP。 第一個24小時,血鈉上升5.8±2.8 mmol/L。 第二個24小時,血鈉上升 4.5±2.2 mEq/L。作者的結論是: 3%生理鹽水加desmopressin 似乎是糾正低血鈉的一個有效策略。
兩個小小的研究,沒有對照,證明了一點,3%生理鹽水加DDAVP 可以減慢糾正低血鈉的速度。
這個辦法,就是用藥物,使腎髒喝水,稀釋血鈉,從而減慢糾正低血鈉的速度。這個辦法,在我看來荒唐離奇。減慢糾正低血鈉速度的方法很多: 減慢3%生理鹽水輸液速度,靜脈滴注5%葡萄糖水,或者張開嘴巴喝水。任何一個方法,都更簡單,更容易控製,更可以預測。
想到這個方法,已經荒唐。居然上了uptodate推薦使用,更荒唐。
查完雜誌,告訴同事我的發現和結論後,給uptodate 發了一個email,希望他們停止推薦這個方法。7-8年過去,uptodate 仍然在推薦。
Uptodate 是美國加拿大醫生的聖經,也是我總是查閱的臨床指南。Uptodate 不僅告訴我怎麽診斷治療,還列出證據。 這些證據給我的幫助更大,促使我思考。 然而,即使是uptodate, 也會鬧笑話。 醫學,或者任何科學的基本原則之一,就是總是懷疑。
參考文獻
[1] Use of Desmopressin Acetate in Severe Hyponatremia in the Intensive Care Unit | American Society of Nephrology (asnjournals.org)
[2] Hypertonic Saline and Desmopressin: A Simple Strategy for Safe Correction of Severe Hyponatremia – ClinicalKey
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