hypotonic dehydration
Introduction
Introduction to hypotonic dehydration Hypotonic dehydration refers to the simultaneous loss of water and sodium, but the lack of water is less than sodium deficiency, the serum sodium is lower than the normal range, the extracellular fluid is hypotonic, the body reduces the secretion of antidiuretic hormone, and the water is in the renal tubule. The resorption is reduced, and the urine output is increased to increase the osmotic pressure of the extracellular fluid. However, the amount of extracellular fluid is inversely reduced. Interstitial fluid enters the blood circulation, although it partially compensates for blood volume, but reduces the interstitial fluid more than the plasma. Faced with a significant reduction in circulating blood volume, the body will no longer consider osmotic pressure and try to maintain blood volume. basic knowledge The proportion of illness: 0.97% Susceptible population: surgical patients Mode of infection: non-infectious Complications: shock
Cause
Cause of hypotonic dehydration
Body factor (45%)
The kidneys discharge too much water and sodium, and long-term use of diuretics to inhibit renal tubular reabsorption of sodium. At the same time, the interstitial fluid enters the blood circulation, partially compensating for blood volume and maintaining circulating blood volume. If too much salt is lost or salt loss continues, the water continues to be excreted from the urine. The extracellular fluid osmotic pressure drops, and the water is transferred from the cells to the cells. The blood volume and interstitial fluid are significantly reduced, and hypovolemia occurs. shock.
Gastrointestinal dysfunction (20%)
Sustained loss of gastrointestinal digestive juice, such as diarrhea, vomiting, digestive tract spasm, intestinal obstruction, etc., sodium with a large loss of digestive juice, patients with fatigue, dizziness, numbness of hands and feet, thirst is not obvious.
Trauma (15%)
Large wound surface exudate, such as burns, extensive exudate loss after surgery, patients with unconsciousness, weakened or disappeared tendon reflexes, stupidity, and even coma.
Prevention
Hypotonic dehydration prevention
The key to preventing this disease is vomiting, diarrhea or correct hydration after surgery.
1, avoid animal fat and greasy food.
2, avoid tobacco, alcohol and spicy spicy food.
3, avoid mold, fried, smoked, pickled food.
4, quit smoking, alcohol, coffee and other excitable drinks.
Complication
Hypotonic dehydration complications Complications
The most common complication of this disease is shock.
Symptom
Symptoms of hypotonic dehydration Common symptoms Pulse tachycardia Muscle spasm painful fatigue Blood presents concentrated hyponatremia stunned dizzy dehydration
According to the degree of sodium deficiency, common symptoms include dizziness, blurred vision, weakness, short pulse, severe unconsciousness, muscle spasm, weak tendon reflexes, coma, etc. According to the degree of sodium deficiency, clinical hypotonic The lack of water is three degrees:
1. Mild sodium deficiency: The patient has fatigue, dizziness, numbness in the hands and feet, and thirst is not obvious. The serum sodium is below 135mmol/L, and the sodium in the urine is reduced.
2, moderate sodium deficiency: In addition to the above symptoms, often have nausea, vomiting, rapid pulse, blood pressure instability, blurred vision, less urine, serum sodium below 130mmol / L.
3, severe sodium deficiency: patients with unconsciousness, tendon reflexes weakened or disappeared, stupid, and even coma, often shock, serum sodium below 120mmol / L.
Examine
Hypotonic dehydration inspection
1, urine Na + determination, often significantly reduced.
2, serum Na + determination below 135mmol / L, indicating hyponatremia, and can determine the degree of sodium deficiency.
3. Plasma osmotic pressure is reduced.
4, red blood cell count, hemoglobin amount, hematocrit, blood non-protein nitrogen and urea are increased, and urine specific gravity is below 1.010.
Diagnosis
Diagnostic identification of hypotonic dehydration
According to the history of fluid loss and the above clinical manifestations, the general diagnosis is not difficult, and the diagnosis can be confirmed by the following examination.
a. U+ determination of urine is often significantly reduced.
b. Serum Na+ determination below 135mmol/L indicates hyponatremia and can determine the degree of sodium deficiency.
c. Reduced plasma osmotic pressure.
d. Red blood cell count, hemoglobin amount, hematocrit, blood non-protein nitrogen and urea are increased, and urine specific gravity is below 1.010.
