Diagnosis and management of the syndrome of inappropriate secretion of antidiuretic hormone after thoracotomy
- VernacularTitle:开胸手术后抗利尿激素分泌失调综合征的诊断和处理
- Author:
Qingchen WU
- Publication Type:Journal Article
- Keywords:
Thoracotomy;
SIADH;
Diagnosis;
Management
- From:
Journal of Chongqing Medical University
1986;0(04):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the diagnosis and management of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) after thoracotomy.Methods:The clinical data of three patients with SIADH after thoracotomy (1 radical operation of esophageal carcinoma,1 radical operation of cardia carcinoma,1 pulmonary lobectomy) were analyzed retrospectively.Results:All 3 patients were males with an average age of 71.4(67.5～74)years.Psychiatric symptoms (the state of delirium) were manifestated by all patients during 3rd to 4th day after thoracotomy,and meanwhile their serum sodium decreased significantly(125～126mmol/L);urine sodium increased abnormally(74.9～101 mmol/L);plasma osmolality decreased(255～280mosm/kg H_2O) and osmolality of urine rised(540～695mosm/kg H_2O).The psychiatric symptoms of 3 patients disappeared and their serum sodium,urine sodium,plasma osmolality,osmolality of urine reversed to normal after water restriction(800～1000ml/24h) for 4 to 6 days.Conclusion:The causes of SIADH after thoracotomy may be related to positive pressure respiration,fierce mental stress,and severe pain that can cause ADH secretion.
