鞍区肿瘤术后低钠血症的探讨

Investigation of hyponatremia secondary to sella area tumor operation

目的探讨鞍区肿瘤手术后并发低钠血症的病因、发病机制、诊断和治疗方法。方法回顾性分析我科2004年1月至2008年12月诊治的21例鞍区肿瘤手术后并发低钠血症的临床资料。结果 19例患者诊断为脑性盐耗综合征(CSWS),2例诊断为抗利尿激素不适当分泌综合征(SIADH)。经相应治疗后,全部患者低钠血症纠正。结论鞍区肿瘤手术后易发生低钠血症,包括脑性盐耗综合征和抗利尿激素不适当分泌综合征,前者主要是补钠和补充血容量,后者却需限水治疗。中心静脉压监测对其诊治有指导意义。

Objective To study the etiology, mechanism,diagnosis and treatment of hyponatremia secondary to sella area tumor operation. Methods The clinical data of 21 patients with postoperative hyponatremia of sella region tumors, who were treated in our department between January,2004 and December, 2008 were analyzed retrospectively. Results Of 21 patients with postoperative hyponatremia, 19 were CSWS, 2 were SIADH. After treatment, all patients recovered normal blood sodium level. Conclusions Central hyponatremia often appeared after operation in patients with sella tumors. It consists of CSWS and SIADH. Sufficient volume or salt replacement is effective for the former, but water limitation is necessary for the latter. Monitoring the central venous pressure has guiding significance for the diagnosis and treatment of hyponatremia.