颅咽管瘤切除术后低钠血症的诊断和治疗

目的探讨颅咽管瘤切除术后低钠血症的病理生理、诊断和治疗。方法对我科收治的44例颅咽管瘤切除术后发生低钠血症患者的临床资料进行回顾性分析,根据临床症状、实验室检查、中心静脉压确定低钠的程度及类型并进行相应处理。结果除2例病人自动出院外,其余病人的低钠血症得到良好纠正。结论颅咽管瘤术后低钠血症的发生率很高,引起低钠的原因有脑性盐耗综合征和抗利尿激素异常分泌综合征,治疗原则各不同,前者要补液、补盐,后者要适当限水、利尿。

Diagnosis and Treatment of Hyponatremia after Resection of Craniopharyngiomas

Objectives To study the pathophysiology,diagnosis and treatment of hyponatremia after resection of craniopharyngiomas. Methods The clinical data of 44 patients with hyponatremia after resection of craniopharyngiomas in our department was analyzed retrospectively. Based on clinical manifestation,laboratory results and central vein pressure,the level and kind of hyponatremia were determined and proper treatment was done. Results Of 44 patients with hyponatremia after the microsurgery for craniopharyngiomas,42 were cured and 2 left hospital intentionally. Conclusions Hyponatremia is one of the most common clinical manifestation after resection of craniopharyngiomas. Hyponatremia includes cerebral salt wasting syndrome （CSWS） and syndrome of inappropriate secretion of antidiuretic hormone （SIADH）. There is difference in the principal of treatment between CSWS and SIADH. CSWS should be treated by supplemeting sufficient sodium and water,and SIADH should be treated by fluid restriction and diuresis.