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基本外科：電解質（醫學英語）
脫水：病理生理學、實驗室檢測和數值-等滲性脫水（醫學英語）
脫水：病理生理學、實驗室檢測和數值-高滲性脫水（醫學英語）
脫水：病理生理學、實驗室檢測和數值-低滲性脫水（醫學英語）
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Sodium
Sodium is vital for homeostasis and the action potential in the body. It is the predominant molecule that controls water movement in and out of the vascular system.
Sodium is an essential electrolyte that helps maintain the balance of water in and around your cells. It’s important for proper muscle and nerve function. It also helps maintain stable blood pressure levels.
The normal range of serum sodium concentration is 135 to 145 mEq/liter. Hyponatremia and hypernatremia, heavily controlled by ADH, are common problems in surgical patients.
In general, mild forms of hyponatremia and hypernatremia are not a problem, but hyponatremia is more concerning than hypernatremia.
Of the many signs and symptoms associated with each, none of them is specific; none of the signs or symptoms alone would lead a clinician to diagnose a sodium abnormality. A blood test is always required.
Common symptoms of low blood sodium include: Weakness, fatigue or low energy, headache, nausea, vomiting, muscle cramps or spasms, confusion, irritability.
Hyponatremia can be mild (130 to 138 mEq/liter), moderate (120 to 130 mEq/liter) , or severe (<120 mEq/liter).
Both mild hyponatremia and moderate hyponatremia are common but only rarely symptomatic.
Severe hyponatremia, however, can cause headaches and lethargy; patients can become comatose or have seizures, although chronic severe hyponatremia can often be asymptomatic.
Hyponatremia is a problem when cells swell as a result of the body’s decreased ability to maintain homeostatic osmolality outside the cells.
The patient’s fluid volume status is critical in assessing hyponatremia. In general, hyponatremia is thought of as either renal or extrarenal.
Excretion of sodium by the kidneys is due to renal failure or to problems with ADH or diuretics.
Extrarenal causes include sodium loss due to wounds, burns, sweating, congestive heart failure, cirrhosis, hypothyroidism, GI losses（Gastrointestinal losses）, and cerebral salt-wasting syndrome.
The Risk for Low Sodium in Blood
Certain factors increase the risk of low blood sodium, including:
old age, diuretic use, antidepressant use, being a high-performance athlete, living in a warmer climate, eating a low-sodium diet, having heart failure, kidney disease, syndrome of inappropriate anti-diuretic hormone (SIADH), or other conditions.
Treatment for low blood sodium
Treatment for low blood sodium varies depending on the cause. It may include: cutting back on fluid intake, adjusting the dosage of diuretics, taking medications for symptoms such as headaches, nausea, and seizures, treating underlying conditions.
參考譯文：
鈉
鈉對體內平衡和動作電位至關重要。它是控制水進出血管系統的主要分子。
鈉是一種必需的電解質，有助於維持細胞內和細胞周圍的水平衡。這對肌肉和神經的正常功能很重要。它也有助於維持穩定的血壓水平。
血清鈉濃度正常範圍為135～145meq/l。低鈉血症和高鈉血症是外科患者常見的問題，ADH控制了低鈉血症和高鈉血症。
一般來說，輕度低鈉血症和高鈉血症不是問題，但低鈉血症比高鈉血症更令人關注。
在各種症狀和體徵中，沒有一種是特異性的；單一的症狀和體徵都不能讓臨床醫生診斷鈉異常。一般需要驗血。
低血鈉的常見症狀包括：
虛弱、疲勞或低能、頭痛、噁心、嘔吐、肌肉痙攣或痙攣、精神錯亂、易怒。
低鈉血症可以是輕度（130至138meq/升）、中度（120至130meq/升）或重度（<120meq/升）。
輕度低鈉血症和中度低鈉血症都很常見，但很少有症狀。
然而，嚴重低鈉血症可導致頭痛和嗜睡；患者可能會昏迷或癲癇發作，儘管慢性嚴重低鈉血症通常是無症狀的。
當細胞膨脹時，低鈉血症是一個問題，這是由於身體維持細胞外穩態滲透壓的能力下降所致。
在評估低鈉血症時，患者的液體容量狀態至關重要。一般來說，低鈉血症被認為是腎性或腎外性。
腎臟排出鈉是由於腎功能衰竭或ADH或利尿劑的問題。
腎外原因包括因傷口、燒傷、出汗、充血性心力衰竭、肝硬化、甲狀腺功能減退、胃腸道功能減退（胃腸道功能減退）和腦性鹽耗症候群引起的鈉流失。
血液中鈉含量低的風險
某些因素會增加低血鈉的風險，包括：
老年、利尿劑使用、抗抑鬱劑使用、高性能運動員、生活在溫暖的氣候中、食用低鈉飲食、患有心力衰竭、腎病、抗利尿激素異常分泌症候群（SIADH）或其他疾病。
低鈉血症的治療
低鈉血症的治療方法因病因而異。它可能包括：減少液體攝入，調整利尿劑的用量，服用治療頭痛、噁心和癲癇等症狀的藥物，治療基礎疾病。
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重點詞彙
homeostasis [ˌhoʊmiəˈsteɪsɪs] 內環境穩定
action potential 動作電位
predominant [prɪˈdɑːmɪnənt] 佔主導的
weakness 疲勞
fatigue [fəˈtiːɡ] 疲倦
headache 頭痛
muscle cramps [ˈmʌsl kræmps] 肌肉痙攣
spasms [ˈspæzəmz] 肌痙攣
confusion [kənˈfjuːʒn] 精神錯亂
irritability [ɪrɪtəˈbɪləti] 易怒
symptomatic [sɪmptəˈmætɪk] 有症狀的
lethargy [ˈleθərdʒi] 嗜睡
comatose [ˈkoʊmətoʊs] 昏睡
seizures [ˈsiʒərz] 癲癇
asymptomatic [ˌeɪsɪmptəˈmætɪk]無症狀的
extrarenal 腎外的
congestive heart failure 充血性心力衰竭
cirrhosis [səˈroʊsɪs] 肝硬化
hypothyroidism [ˌhaɪpoʊˈθaɪrɔɪdɪzəm] 甲狀腺功能減退
GI losses（Gastrointestinal losses）：胃腸道丟失。是指通過大便丟失液體、電解質、血液、蛋白質或其他物質。
cerebral salt-wasting syndrome 腦性鹽耗症候群
antidepressant [ˌæntidɪˈpresnt] 抗抑鬱藥
SIADH (syndrome of inappropriate antidiuretic hormone secretion) 抗利尿激素異常分泌症候群
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