颅咽管瘤术后并发症的防治

目的探讨颅咽管瘤切除术后并发症的特点和处理原则。方法回顾性分析82例颅咽管瘤病人的临床资料,均经手术治疗,术后监测水、电解质和血糖变化,并记录24 h尿量。结果肿瘤全切除75例,次全切除7例。颅咽管瘤术后并发症较多,其中尿崩症78例,钠代谢紊乱74例,垂体功能低下67例,高热17例,精神障碍11例,意识障碍4例,深静脉血栓4例,癫癎3例。随访17-36个月,平均28个月,恢复正常生活和学习68例,仅能生活自理8例,不能生活自理4例,死亡2例。结论颅咽管瘤术后并发症较多,早期监测和及时处理可进一步提高该病的治愈率。

Prevention and treatment of postoperative complications after surgery for craniopharyngioma

Objective To explore the characteristics and treatment principles for surgical complications of craniopharyngiomas. Methods Clinical data of 82 patients withcraniopharyngiomas undergoing surgery were analyzed retrospectively. The changes of water, electrolyte and blood glucose were detected, and the urinary volume in 24 h was recorded. Results Total tumor resection was achieved in 75 patients and subtotal resection in 7. There were many postoperative complications of craniopharyngioma, including diabetes insipidus in 78 patients, metabolic disturbance of sodium in 74, hypopituitarism in 67, hyperpyrexia in 17, mental disorder in 11, consciousness disturbance in 4, deep vein thrombosis in 4 and epilepsy in 3. All the patients were followed up for mean period of 28 month, ranged from 17 to 36 months. Normal life and learning was found in 68 patients, self-care ability in 8, no self-care ability in 4 and death in 2. Conclusion Postoperative complications of craniopharyngioma are common, and early monitoring and timely treatment can increase the cure rate.