经蝶垂体瘤切除术后低钠血症的临床分析

目的探讨经蝶垂体瘤切除术后低钠血症的临床过程及其特点。方法回顾分析经蝶垂体瘤切除术后低钠血症患者11例。结果经蝶垂体瘤切除60例,术后发生低钠血症11例(18.3%)。2例发生在术后第1天,其余9例发生在术后4~9d,属于迟发性低钠血症。血钠一般是先缓慢下降,而后大幅度降至最低点,平均124mmol/L(范围112~132mmol/L)。7例(64%)有头痛、恶心、呕吐、昏迷等合并症,但都短暂可逆。治疗主要包括限制液体入量和补充钠盐两方面。11例患者均在治疗后7d内血钠恢复正常。结论经蝶垂体瘤切除术后低血钠症的临床过程具有一定特点。若及时发现,正确治疗,均可很快恢复正常。

The clinical analysis of hyponatremia after transsphenoidal surgery of ditritary adenoma

Objective:To examine clinical course and characteristics of hyponatremia after transsphenoidal surgery for pituitary adenomas.Methods:Retuospectively examining 11 patients with hyponatremia,which developed after transsphenoidal surgery for pituitary adenomas.Results:Sixty patients reviewed who underwent transsphenoidal pituitary surgery,11 patients(18.3%) were discovered hyponatremia.Two patients developed hyponatremia on the very first postoperative day following surgery.The remaining 9 patients developed hyponatremia with a few days between day 3 and day 9 after surgery,which was defined as delayed hyponatremia.Mean serum sodium showed a tendency towards a mild decrease on the first postoperative day,followed by a significant drop to the nadir 124 mmol/L(range112～132 mmol/L).Seven patients(64%) reported headache,nausea,vomiting or emesis.But the symptoms were transient and reversible.Treatment consisted of water restriction and salt supplement.In all patients,hyponatremia resolved within 7 days after treatments.Conclusion:Hyponatremia after transsphenoidal surgrry for pituitary adenomas has its own characteristic.If discovered in time and treated properly,patients would recover quickly.