经蝶垂体腺瘤术后低钠血症

目的 探讨经蝶垂体腺瘤术后发生低钠血症的相关因素、诊断和治疗方法。方法 回顾性分析2004年1月-2005年1月期间，在我科行经蝶垂体瘤切除术的216例患者的临床资料。结果 在216例患者中，有47例（21．8％）术后出现低钠血症。其中，42例（89．3％．42／47）表现为脑性盐耗综合征，5例（10．7％，5／47）表现为抗利尿激素分泌不当综合征。低钠血症与年龄、肿瘤大小有关，与性别无关；47例患者经相应治疗后低钠血症恢复。结论经蝶垂体腺瘤术后中枢性低钠血症多见于老年和垂体大腺瘤患者，包括脑性盐耗综合征（CSWS）和抗利尿激素分泌不当综合征（SIADH），治疗前者以补钠和补充容量为主，后者却需限水治疗。

Hyponatremia after Transsphenoidal Resection of Pituitary Adenoma

Objective To study the associated factors,diagnosis and treatment of hyponatremia after transphenoidal resection of pituitary adenoma.Methods Retrospectively reviewed the data of 216 patients who underwent pituitary surgery between January 2004 and January 2005 in our department.Results 47(21.8%,47/216) patients had post-operative hyponatremia.Among them,42 (89.3%,42/47) cases with cerebral salt wasting syndrome(CSWS).5 (10.7%,5/47) cases with syndrome of inappropriate antidiuretic hormone(SIADH).The occurrence of hyponatremia was related to the age and tumor size,but not to the sex.All of the 47 cases were cured.Conclusions Central hyponatremia often appeared in elderly and in patients with macro adenomas.It consists of cerebral salt wasting syndrome(CSWS) and syndrome of inappropriate antidiuretic hormone(SIADH).The principle of treatment was salt and fluid replacement for the former,but water limitation is necessary for the later.