鞍区术后神经源性尿崩症的处理

Management of neurogenic diabetes insipidus after sella operation.

目的 探讨术后尿崩症的发生特点及其处理原则。方法 91例鞍区病变患者 ,其病变部位包括鞍内、鞍上、鞍旁、鞍后、上斜坡、第三脑室底、第三脑室内等。均经手术获得病理诊断。结果 术后尿崩症主要发生于颅咽管瘤病例 ,尤其是病变较大和术前即有尿崩症者 ;病变部位高者容易发生永久性尿崩症。尿崩症所导致的电解质紊乱与术后的处理有关。结论 鞍区手术后尿崩症的正确处理是患者获得良好疗效的关键因素之一 ;

Objective To explore the characteristics and treatment principle of postoperative diabetes insipidus(DI).Methods The lesion involved intrasella,supersella,parasella,postsella,superior clivus,the third ventricle floor,and the interior third ventricle in 91 cases of sella lesion,which were confirmed by pathology.Results The postoperative DI occurred mainly in the craniopharyngioma cases,especially the cases with large size of lesion and preoperative DI.The DI was also related to the location of the lesion.The higher the location of the sella lesion,the easier the permanent DI occured.The disturbance of electrolytes caused by DI were related to the incorrect postoperative treatment.Conclusion The correct treatment of DI after sella operation is one of the key factors influencing the curative effect,which should be managed in coordination with other complications.