本文将对小儿危重症的电解质异常和酸硷平衡的临床特征及治疗重点说明。血清钠异常一、低钠血症(1)丢失性低钠血症:见于婴儿腹泻、先天性幽门狭窄、伴高钾血症的先天性肾上腺皮质增生、急性肾上腺功能不全、肾上腺出血等。表现为周围循环衰竭、休克、意识障碍,应补充高张或生理盐水。(2)稀释性低钠血症:见于肾病综合征、充血性心力衰竭、ADH分泌异常综合征、水中毒等,肺、脑水肿也可引起。严重时有意识障碍及惊厥等神经症状。治疗原则为限制水,需补液时应补必须量的60～80%。一般禁忌补钠,但低钠血症严重时,如少量输液及点滴高张盐水,则常能改善钠浓度。如过于迅速纠正低钠血症则引起桥脑脱髓鞘,后遗中枢神经损害。二、高钠血症:婴儿急剧地 This article will highlight the clinical features and treatment of electrolyte abnormalities and acid-base balance in children with critical illness. Serum sodium abnormalities, hyponatremia (1) loss of hyponatremia: found in infantile diarrhea, congenital pyloric stenosis, congenital adrenal hyperplasia with hyperkalemia, acute adrenal insufficiency, adrenal hemorrhage and so on. The performance of the surrounding circulatory failure, shock, disturbance of consciousness, should be supplemented with high tension or saline. (2) dilutional hyponatremia: seen in nephrotic syndrome, congestive heart failure, ADH secretion syndrome, water poisoning, lung, brain edema can also cause. Serious disorders such as consciousness and convulsions and other neurological symptoms. The principle of treatment is to limit the water, need to make up the required amount of 60 to 80% when rehydration. General contraindications make sodium, but severe hyponatremia, such as a small amount of infusion and intravenous hypertonic saline, often can improve the sodium concentration. If too quickly correct hyponatremia is caused by pons demyelination, central nervous system damage. Second, hypernatremia: infants rapidly