鞍区肿瘤术后低钠血症原因诊断及处理对策

目的探讨鞍区肿瘤手术后并发低钠血症的病因、发病机制、诊断及治疗方法。方法回顾性分析32例鞍区肿瘤术后低钠血症患者的临床表现和实验室检查，总结有效的诊断及治疗方法。结果32例中临床诊断抗利尿激素分泌异常综合征12例，脑性盐耗综合征18例，余2例因连续数日尿量／d〉5000ml而诊断为尿崩症未列入统计范围；均恢复良好。结论鞍区肿瘤术后低钠血症出现后，尿量、尿比重的变化以及试验性限水治疗有助于鉴别抗利尿激素分泌异常综合征和脑性盐耗综合征；病因未明时，应首选限水治疗。

Etiological diagnosis and treatment of hyponatremia for postoperatine sella area neoplasm

Objective To explore the etiology,mechanism,diagnosis and treatment of hyponatremia following surgery for sella area neoplasm.Methods Clinical manifestations and laboratory examination of 32 cases of hyponatremia following surgery for sella area neoplasm were retrospectively analyzed.Results 12 cases were diagnosed as syndrome of inappropriate antidiuretic hormone(SIADH),and 18 as cerebral salt wasting syndrome(CSWS),and the rest two cases were excluded becanse their urine volume vas>5 000 ml a day and was diagnosed as diabetes insipidns but all 32 cases recovered well.Conclusion Urine volume and urine specific gravity as well as experimental restriction of liquid infusion can better differentiate SIADH and CSWI after the patients develop hyponatremia following surgery for sella area neoplasm.Liquid restriction therapy is the top priority for therapy as the etiology is unknown.