小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 寻找水和饮酒
其他诊断因素
- 激越
- 多尿
- 头痛
- 恶心或呕吐
- 昏睡或意识错乱
- 癫痫发作、谵妄或昏迷
危险因素
- 精神障碍
- 神经发育障碍性疾病
- 吸烟
- 酗酒
诊断性检查
首要检查
- 血浆渗透压
- 尿渗透压
- 尿钠
- 血清钠
- 24 小时尿容量
- 尿液分析
- 血清尿素
- 限水试验
需考虑的检查
- 加压素试验
- 血浆抗利尿激素
治疗流程
严重低钠血症 (<125 mmol/L [<125 mEq/L]),或伴随神经症状
低钠血症 (<125~130 mmol/L [<125~130 mEq/L]) 或伴随 GI 症状
慢性烦渴
撰稿人
作者
Shilpa Srinivasan, MD, DFAPA, DFAAGP
Vice Chair, Medical Staff Affairs, Behavioral Health Midlands, Prisma Health
Professor of Clinical Psychiatry
Program Director: Geriatric Psychiatry Fellowship
Director: Psychiatry Acting Internship and M4 Clerkship
Department of Neuropsychiatry and Behavioral Science
Prisma Health - University of South Carolina School of Medicine Columbia
Columbia
SC
利益声明
SS is a board member of the American Association for Geriatric Psychiatry and serves on the Geriatric Psychiatry Exam Committee for the American Board of Psychiatry and Neurology.
Meera Narasimhan, MD, DFAPA
Professor and Chair
Department of Neuropsychiatry and Behavioral Science
Senior Medical Director
Prisma Health
Special Advisor to University of South Carolina President
Health Innovations and Economic Development
University of South Carolina School of Medicine Columbia
Columbia
SC
利益声明
MN is a member of an advisory board for Alkermes.
鸣谢
Dr Shilpa Srinivasan and Dr Meera Narasimhan would like to gratefully acknowledge Dr Emily Williams and Dr Brian Dundas, previous contributors to this topic.
利益声明
EW declares that she has no competing interests. BD is an author of one of the references for this topic.
同行评议者
Branimir Margetić, MD
Neuropsychiatric Hospital "Dr Ivan Barbot"
Popovaca
Croatia
利益声明
BM is an author of a reference cited in this topic.
Aaron Pinkhasov, MD, DFAPA, FACLP
Chairman
Department Of Psychiatry
NYU Langone Hospital
Professor of Psychiatry and Medicine
NYU Long Island School of Medicine
Long Island
NY
利益声明
AP declares that he has no competing interests.
Richard C Millson, MD, DTM&H, FRCPC
Associate Professor of Psychiatry
Queen's University
Kingston
Ontario
Canada
利益声明
RCM declares that he has no competing interests. He is the author of some of the references cited in this topic.
鉴别诊断
- 尿崩症
- 利尿剂
- 脑性盐耗
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精神性烦渴
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