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I.はじめに
一般にADH(antidiuretic hormone)の過剰によるとされるSIADH(syndmme of inappropriate secre-tion of ADH)は1957年Schwartz & Bartter9)らの肺癌の報告以来,数多くみられる.脳外科疾患においても髄膜炎,くも膜下出血,頭部外傷,慢性硬膜下血腫などの症例によるSIADHの報告7)がみられる.
今回,われわれはフロセミドおよび高張食塩水の併用が低Na血症と意識検査の改善に有効であった頭部外傷後のSIADHの1症例を経験したので,文献的考察も含めて報告する.
A case of SIADH after head injury was encounter-ed and treated successfully with furosemide and hyper-tonic saline. 250 mg of furosemide was given twiceat two hours' interval. The dose of 2.5% saline for theinfusion was calculated according to the excretion ofsodium in the urine collected during this period. The level of serum sodium quickly rose from 113mEq/1 to 137 mEq // in 33 hours. The consciousnessof the patient returned to normal.
The problems of quick correction of hyponatremiaincluding the central pontine neurolysis were discussed
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