颅咽管瘤术后肺动脉栓塞的研究

Study of pulmonary embolism in postoperative patients with craniopharyngioma

目的研究颅咽管瘤术后肺动脉栓塞的发生情况及可能原因。方法回顾性分析185例颅咽管瘤病人的临床资料,其中发生肺动脉栓塞5例（2.7%）,经CT肺动脉造影证实4例。对5例病人的血电解质水平、去氨加压素及地塞米松的使用进行研究。结果随访5例,时间6~30个月,死亡3例,痊愈2例。3例病人血钠持续高于正常值（145~170 mmol/L）。5例病人均至少使用1个月的去氨加压素及7 d的地塞米松。结论高钠血症、长期使用去氨加压素和地塞米松可能诱发血液高凝状态而增加病人术后发生肺动脉栓塞的风险。

Objective To study the occurrence of pulmonary embolism in the postoperative patients with craniopharyngioma and possible reasons.Methods The clinical data of 185 patients with craniopharyngioma were analyzed retrospectively.Pulmonary embolism occurred in 5 patients（2.7%）,4 of which were confirmed by CT pulmonary angiography.The plasma electrolyte level and the use of desmopressin and dexamethasone were studied.Results Five patients were followed up for 6 to 30 months,2 patients recovered and 3 died.The serum sodium levels of 3 patients were from 145 to 170 mmol/L and remained to be higher than the normal range.All the patients were treated with desmopressin and dexamethasone for at least 1 month and 7 days respectively.Conclusions Hypernatremia and long-term use of desmopressin and dexamethasone may increase the risk of pulmonary embolism in the postoperative patients with craniopharyngioma.