垂体腺瘤术后低钠血症与癫痫的关系

Hyponatremia and Epilepsy Relationship after Surgical Treatment of Pituitary Adenoma

背景与目的:垂体瘤术后发生癫痫的原因与脑水肿密切相关,本文旨在研究垂体瘤术后低钠血症与癫痫的关系。方法:对11例垂体瘤术后血钠水平进行监测,分别统计癫痫发作前24～12h、发作时的血钠值。按血钠值和血钠的变化幅度进行分组,组1血钠值≥125mmol/L,变化幅度≥15mmol/L;组2血钠值<125mmol/L,变化幅度<15mmol/L,用T和!2检验来分析癫痫与术后血钠的关系。结果:癫痫前24～12h血钠平均值与癫痫时血钠值的比较有统计学意义(P<0.001),血钠≥125mmol/L组与<125mmol/L组的血钠变化有统计学意义(P<0.035)。其他各组之间不具有统计学意义。结论:垂体瘤术后血钠紊乱者发生癫痫可能性大,其中变化幅度越大越易发生癫痫。垂体瘤术后血钠偏低是癫痫的诱发因素。

BACKGROUND ＆ OBJECTIVE：To analysis the relationship between the epilepsy and degree of hyponatremia after surgical treatment of pituitary adenoma. METHODS： Serum sodium level of 11 cases of pituitary adenoma after surgery were monitored. Patients were grouped according to the mean serum sodium level 12 to 24 hours before seizure and during seizure. Group1 were patients having mean serum sodium of 125mmol/L or greater and the fluctuation was greater than or Equal to15mmol/L. Group2 were patients having mean serum sodium level less than 125mmol/L and the fluctuation was less than 15mmol/L. These groups were compared and analyzed by T and χ^2 test .The serum sodium levels at the time of seizure attack are also recorded. RESULTS： Groups with mean serum sodium level of equal to or greater than 125mmol/L showed statistical difference in development of post-operative seizure to those below 125mmol/L in both pre-seizure （12-24 hours） （P=0.035） and during seizure condition （P=0.001）. CONCLUSION： Pituitary adenoma post-operative seizure could be due to serum sodium fluctuation.The lower the mean serum sodium level and the greater the fluctuation, the more susceptible to post-operative seizure the patients would be.