The Clinical Research Of Decompensated Cirrhosis With Hyponatremia

Background:Hyponatremia is the common condition in decompensated liver cirrhosis due to various reasons. In recent years, many studies have shown that hyponatremia is closely related with the occurrence of complications of cirrhosis, and affect the prognosis of patients with cirrhosis. Diagnosis, treatment and prevention of hyponatremia in cirrhosis has begun to attract widespread attention.Methods:Retrospective analysis of liver function with Child-Pugh score, occurrence of complications, and the short term (30days) mortality. According to serum sodium level, the patients were divided into normal group, hyponatremia group and the hyponatremia group was further divided into three group:mild, moderate and severe group to analyze the relationship between hyponatremia and the incidences and the severities of complications of cirrhosis, Child-Pugh grade, and the short term (30days) mortality.Results:281cases had hyponatremia in804decompensated liver cirrhosis patients The incidence rate was about34.95%. The cases of mild, moderate and server hyponatremia was182,64and35and accounting for64.77%,22.78%and12.46%in the patients with hyponatremia respectively; The Child-Pugh grade was higher in hyponatremia group compared with normal serum sodium group; the lower serum sodium, the higher proportion of C-class Child-Pugh grade; The incidence of hepatic encephalopathy, hepatorenal syndrome, spontaneous bacterial peritonitis and refractory ascites was significantly higher, and with the severity of hyponatremia increased, the occurrence rate increased gradually, the difference was statistically significant; With higher short-term mortality (30days) in hyponatremia group compared with normal group and the mortality was significantly higher than other groups in severe hyponatremic group with three cases death(10.00%), the difference was statistically significant; Complementation of sodium in the treatment of patients with severe hyponatremia can improve the status of the hyponatremia and the output of urine increased significantly, the difference was statistically significant. However there was no significant difference between the groups for the incidence of upper gastrointestinal bleeding;Conclusions:1). The hyponatremia is closely related with Child-Pugh grade of liver function, the lower the serum sodium levels, the worse liver function and the poor prognosis;2). The hyponatremia and its severity has correlation with the incidence of the complications such as hepatic encephalopathy, hepatorenal syndrome, spontaneous bacterial peritonitis and refractory ascites, the lower the serum sodium levels, the higher incidence of these complications;3). The hyponatremia and its severities have correlations with the short-term mortality (30days), The lower the sodium concentration, the higher short-term mortality;4). For patients with severe hyponatremia, the complementation of sodium in the treatment can correct the hyponatremia status, and increase urine output.