肺癌并发抗利尿激素不适当分泌综合征2例报告及文献复习

摘要

Objective:To analyze the clinical materials of 2 patients with lung cancer complicated with syndrome of inappropriate secretion of antidiuretic hormone (SIADH),and to improve the clinical awareness and management.Methods:One patient was treated with lung cancer chemotherapy alone for 7 courses.The other patient received the strictly limited for liquid intake and tolvaptan by oral against hyponatremia without chemotherapy.Results:With the relapsing and advancing of lung cancer,the hyponatremia and its relevant symptoms of the first patient were poorly relieved.While the level of serum sodium of the second patient returned to the normal level 3 d after administration of tolvaptan.Conclusion:About one-third of the patients with hyponatremia have SIADH.The etiological treatment and symptomatic therapy of hyponatremia should be given to the patients in clinical treatment.%目的:分析2例肺癌并发抗利尿激素不适当分泌综合征(SIADH)患者的临床资料,提高对该病的临床认识和管理.方法:患者1单纯采用肺癌化学药物治疗,完成7个疗程化疗.患者2未行肺癌病因治疗,通过严格限制液体量摄入及口服托伐普坦治疗低钠血症.结果:伴随肺癌反复进展,患者1低钠血症及相关临床症状缓解欠佳.患者2口服托伐普坦3 d后血钠水平恢复正常.结论:约1/3低钠血症患者出现SIADH,临床治疗中应给予针对低钠血症的病因治疗和对症治疗.