颅咽管瘤术后钠代谢紊乱21例分析

目的 分析颅咽管瘤切除术后钠代谢紊乱与肿瘤部位及切除程度的相关性.方法 对我院2006年2月至2010年10月30例颅咽管瘤手术切除术后发生钠代谢紊乱的21例患者的临床资料进行回顾性分析.结果 30例患者中术后出现高钠血症10例,低钠血症9例,高钠、低钠交替出现2例.死亡1例.肿瘤部位与术后发生钠代谢紊乱情况:鞍内未发生,鞍内-鞍上8例(61.5%,8/13),鞍后鞍旁3例(60.0%,3/5),三脑室及侧脑室10例(100.0%,10/10);肿瘤部位与术后发生钠代谢紊乱有关(x2=9.63,P<0.05).肿瘤切除程度与术后出现血钠异常情况:全切除患者发生血钠异常15例(62.5%,15/24),次全切除4例(100.0%,4/4),部分切除2例(100.0%,2/2)),肿瘤切除程度与术后出现血钠异常无关(x2=3.21,P>0.05).结论 颅咽管瘤切除术后钠代谢紊乱可能与肿瘤的部位有关,而与肿瘤的切除程度无关.

Abstract：

Objective To analyze the correlation between the position and the removal extent of the tumor and the postoperative sodium metabolic disturbance in patients with craniopharyngiomas. Methods Retrospective analysis of the postoperative sodium metabolic disturbance in craniopharyngioma patients admitted from Feb.2006 to Oct. 2010 was performed. Results In the 30 casese,10 cases occurred hypernatremia,9 with hyponatremia and, 2 with fluctuating hyponatremia and hypematremia. One cases died in the population. No sodium metabolic disturbance occurred in patients with craniopharyngiomas located in the interasellar region, whereas 8 occurred in the inter and suprasellar region(61.5% ,8/13) , and 3 occurred post and beside assellar region(60.0% ,3/5) , 10 occurred in the third and lateral cerebral ventricle (100.0%, 10/10). Sodium metabolic disturbance occurred in 15 cases(62. 5% ) among 24 cases underwent total resection,in all 4 cases underwent sub-total resection (100.0% ) ,and all 2 cases underwent paritical resection ( 100. 0% ). The degree of resection was not correlated with Sodium metabolic disturbance(x2 = 3.21 ,P>0.05). Conclusion Sodium metabolic disturbance after craniopharyngioma surgery may be correlated with the position of tumor, but not correlated with the removal extent.

Analysis of postoperative sodium metabolic disturbance for craniopharyngiomas in 21 cases QIN

Objective To analyze the correlation between the position and the removal extent of the tumor and the postoperative sodium metabolic disturbance in patients with craniopharyngiomas. Methods Retrospective analysis of the postoperative sodium metabolic disturbance in craniopharyngioma patients admitted from Feb.2006 to Oct. 2010 was performed. Results In the 30 casese,10 cases occurred hypernatremia,9 with hyponatremia and, 2 with fluctuating hyponatremia and hypematremia. One cases died in the population. No sodium metabolic disturbance occurred in patients with craniopharyngiomas located in the interasellar region, whereas 8 occurred in the inter and suprasellar region(61.5% ,8/13) , and 3 occurred post and beside assellar region(60.0% ,3/5) , 10 occurred in the third and lateral cerebral ventricle (100.0%, 10/10). Sodium metabolic disturbance occurred in 15 cases(62. 5% ) among 24 cases underwent total resection,in all 4 cases underwent sub-total resection (100.0% ) ,and all 2 cases underwent paritical resection ( 100. 0% ). The degree of resection was not correlated with Sodium metabolic disturbance(x2 = 3.21 ,P>0.05). Conclusion Sodium metabolic disturbance after craniopharyngioma surgery may be correlated with the position of tumor, but not correlated with the removal extent.