颅咽管瘤术后并发症的预防及处理（附72例报告）

目的探讨颅咽管瘤切除术后的并发症及其防治措施。方法回顾性分析我科从2004年1月至2009年6月收治的颅咽管瘤患者72例。结果肿瘤全切除38例，次全切除34例。并发症大致可分为尿崩症和水、电解质代谢紊乱、体温调节异常、癫痫发作、上消化道出血、意识障碍、无菌性脑膜炎、脑脊液鼻漏及其它，给予对症或再次手术，治愈及好转出院66例，死亡6例。随访1～60月，随访期中死亡4例，长期尿崩3例，需激素替代治疗12例。结论颅咽管瘤切除术是富于挑战性的手术，并发症发生率高，术后及时发现和处理并发症有助于患者顺利康复。

Prevention and treatment of complications after operation for craniopharyngioma-report of 72 Cases

Objective To explore the complications in excision of craniopharyngioma and prevention and treatment methods. Methods A total of 72 craniopharyngioma patients admitted from Jan 2004 to June 2009 were reviewed. Result 38 patients received complete resection and 34 cases received subtotal resection in this group. Postoperative complications generally included diabetes insipidus, metabolic disturbance of electrolyte, abnormal body temperature, epilepsy and convulsion attacks, upper gastrointestinal bleeding, consciousness disorder, aseptic meningitis and cerebrospinal rhinorrhea etc. All above were given symptomatic treatment or re-operation, 6 cases died, 66 cases were improved or recovered. 4 cases died, 3 cases were long-term diabetes insipidus and 12 cases need hormone replacement therapy during the follow-up for 1 month -60 months Conclusions Excision of craniopharyngioma are very challenging operation, with high complication rates. Early identification and treatment of these complications will help patients to expedite the recovery of their health.