垂体腺瘤术后低钠血症

目的 探讨垂体腺瘤术后低钠血症的相关因素、发病机制和治疗。方法 回顾性总结了1999年1月至2000年6月期间。在本院神经外科就诊的186例垂体腺瘤患者的临床资料。结果 在186例患者中。有72例(38．7％)术后出现低钠血症。其中43例(59．7％,43／72)出现于术后4—7d;43例(59．7％,43／72)有临床症状;低钠血症与年龄、肿瘤大小和肿瘤类型有关。与性别无关;68例(94．4％,68／72)患者被给予补钠和补充容量治疗,63例(87．5％,63／72)在7d内缓解。结论 垂体腺瘤术后低钠血症多出现于术后l周左右。多见于老年和垂体大腺瘤患者。治疗以补钠和补充容量为主。

Hyponatremia after surgery of pituitary adenomas

Objective To clarify the frequency and presentation associated factors,pathogenetic mechanism,treatment and outcome of hyponatremia after surgery of pituitary adenoma.Methods Retrospectively reviewed the data of186patients who underwent pituitary surgery between January1999and June2000in the department.Results72(38.7%,72/186)patients had suffered post-operative hyponatremia.Among them,43(59.7%,43/72)cases the hyponatremia appeared at4to7days postoperatively.43(59.7%,43/72)cases presented with nausea,vomiting,headache,dizziness,confusion and weakness.The symptoms of hyponatremia was related to the age,tumor size and adenoma cell type,but not to the sex,surgical approach and degree of removal.Treatment consisted of salt replacement and mild fluid restriction in4patients and salt and fluid replacement in68patients.Hyponatremia had been resolved within7days in63patients.Conclusions Hyponatremia often appeared about 7days after surgery of pituitary adenoma,especially in elderly and in patients with macroadenomas.The principle of treatment was salt and fluid replacement.