脑膜瘤术后电解质紊乱的变化趋势及影响因素分析

Analysis of variation trends and influencing factors of postoperative electrolyte disturbance in meningiomas

目的探讨脑膜瘤术后电解质紊乱的变化趋势及影响因素。方法回顾性分析94例脑膜瘤手术病人的临床资料,采用单因素分析及非条件Logistic回归分析年龄、病理分型、高血压病、肥胖、肿瘤最大直径、术中输血、术后早期进食等因素与术后电解质紊乱的关系。结果血清低钠、正常、高钠病人比例随术后时间变化差异具有统计学意义(P<0.05),同样血清低钾、正常、高钾病人比例以及低氯、正常、高氯病人比例随术后时间变化差异具有统计学意义(P<0.05)。单因素分析示:脑膜瘤术后电解质紊乱发生率与年龄、高血压病、肥胖、肿瘤最大直径、术中输血、术后早期进食相关(P<0.05)。Logistic回归分析显示合并高血压病(OR=7.82)、肿瘤最大直径≥3 cm(OR=5.97)、术中输血(OR=8.34)是电解质紊乱的独立危险因素(P<0.05),术后早期进食(OR=0.19)是术后发生电解质紊乱的保护因素。结论脑膜瘤术后高钠血症、高氯血症发生较早,电解质紊乱集中在术后1周内;术后电解质紊乱可能与合并高血压病、肿瘤最大直径≥3 cm、术中输血等因素有关。

Objective To explore variation trends and influencing factors of postoperative electrolyte disturbance in meningiomas.Methods Clinical data of 94 patients with meningiomas were analyzed retrospectively,who received surgery.The univariate analysis and unconditioned Logistic regression was used to analyze the relationship between age,hypertension,obesity,maximum diameter of tumor≥3 cm,intraoperative blood transfusion,early feeding and the postoperative electrolyte disorder respectively.Results There was statistical difference in the rate of high,normal and low sodium patients between the different times after surgery(P<0.05).The differences also existed in the rate of high,normal and low potassium and chlorine(P<0.05).The results of univariate analysis showed that the incidence of postoperative electrolyte disorders in meningiomas was significantly correlated with age,hypertension,obesity,the maximum diameter of tumor≥3 cm,intraoperative blood transfusion and early feeding(P<0.05).Logistic regression results showed that patients with hypertension(OR=7.82),the maximum diameter of tumor≥3 cm(OR=5.97),and intraoperative blood transfusion(OR=8.34)were independent risk factors for electrolyte disturbance after surgery for meningiomas(P<0.05).The postoperative early feeding(OR=0.19)was the protective factor for postoperative electrolyte disorders.Conclusions Hypernatremia and hyperchloremia occur early in meningiomas patients after surgery.The electrolyte disturbance was concentrated in the first week after surgery.The postoperative electrolyte disturbance in meningiomas may be related to hypertension,tumor maximum diameter≥3 cm and intraoperative blood transfusion.