颅咽管瘤术前激素改变与术后尿崩症的关系

目的分析颅咽管瘤术前泌乳素（PRL）、促甲状腺激素（TSH）和促肾上腺皮质激素（ACTH）的变化,探讨术前激素变化与术后尿崩症的关系,为术后并发症的防治及预后的评估提供参考依据。方法对2003年3月-2007年6月收治的96例颅咽管瘤患者进行回顾性分析。对患者术前的激素（PRL、TSH及ACTH）检测结果与术后尿崩症的关系进行分析;按照术前有异常的激素种类将患者分为Ⅰ组（术前无激素的改变）、Ⅱ组（术前有任意1种激素发生改变）、Ⅲ组（术前有任意2种激素发生改变）及Ⅳ组（术前3种激素都发生改变）组。分析不同组别与术后尿崩症的关系。结果术前PRL、TSH及ACTH有改变的患者术后尿崩症发生率高于术前上述激素无改变的患者,PRL、TSH及ACTH发生改变的种类越多,术后尿崩症发生率越高。结论术前PRL、TSH及ACTH的改变和改变的种类多少可以作为判定术后并发症和评估预后的参考指标之一。

Relationship between the Hormones Changes in Patients with Craniopharyngioma before the Surgery and Diabetes Insipidus after the Surgery

Objective To observe the changes of prolactin（PRL）,thyroid stimulating hormone（TSH）,and adrenocorticotropic hormone（ACTH）in patients with craniopharyngiomas before surgery;and to analyze the relationship between their changes and incipidus after the surgery to get the basis for postoperative complications and prognosis.Methods Ninety-six patients with craniopharyngiomas from March 2003to July 2007were seleted.The relationship between endocrine changes before surgery and diabetes insipidus after surgery was analyzed.The patients were divided into four groups：no endocrine changed in groupⅠ,one hormone changed in groupⅡ,two hormones changed in groupⅢ,and all the three hormones changed in groupⅣ.The relationship between different groups and diabetes insipidus was analyzed.Results The pre-operative endocrine abnormalities was the sign of hypothalamus injury.There were significantly higher incidences of diabetes insipidus after the surgery in patients with endocrine abnormalities than that in the patients without any endocrine changes.There were significantly different incidence of diabetes insipidus after the surgery in different groups.Conclusion The pre-operative endocrine changes can be the guideline to predict the postoperative diabetes insipidus and to evaluate the prognosis.