颅咽管瘤术后水钠平衡紊乱的预防与处理

目的：探讨颅咽管瘤切除术下丘脑功能损害的预防与治疗方法。方法：23例行颅咽管瘤切除术患者，手术当日及术后每日定时检测血钠并观察尿量变化，根据其变化进行治疗。结果：（1）19例术后并发尿崩症，其中12例术后两周内恢复，5例术后4周内恢复，1例术后1年内恢复，1例术后7d死于高热昏迷；（2）17例术后出现血钠代谢异常，其中13例术后4周内恢复，3例2个月内恢复，1例6个月内恢复。（3）23例病人中肿瘤全切除18例，近全切除5例。结论：颅咽管瘤全切术后绝大多数会出现水钠代谢异常。尿崩症大多数在术后早期恢复，血钠代谢异常需严密监测，针对监测结果治疗。

Prevention and treatment of the balance disorder of water and sodium after resection of craniopharyngioma

Objective To study the prevention and treatment for the patients with the water and blood sodium disorders after surgery.Methods The water and blood sodium in 23 patients with craniopharyngiomas resected surgically were daily observed after surgery.Results Among 23 patients with craniopharyngiomas,19 patients were complicated with diabetes insipidus,12 patients recovered in two weeks after surgery,5 patients recovered in four weeks,one patient recovered in one year and one patient died of the complication of hypothalamus injury seven days after surgery.Among 17 patients with the sodium disorder.13 patients recovered the normal blood sodium level within 4 weeks after surery,3 patients recovered within 8 weeks,and one patient recovered within 6 months.Among 23 patients,total removal of the tumor were conducted in 18 patients,and subtotal removal in 5 patients.Conclusions The water and blood sodium disorder appears in most patients with crainopharyngiomas afer surgery.The patients with diaberes insipidus after operation most recover within 4 weeks after surgery.Treatment of the sodium disorder can be carried out in dependence on the different characteristics of each patient.