鞍区病变术后低钠血症的临床分析

Analysis of postoperative hyponatremia on sella area lesions

目的探讨鞍区病变术后低钠血症的类型、发病原因、发病机制及诊治策略。方法回顾分析35例鞍区病变术后低钠血症患者,通过其临床表现以及实验室检查确立诊断,总结有效的治疗方法。结果 33例低钠血症患者经过3～10d治疗血钠恢复正常,并维持正常血钠水平,痊愈出院;2例由于因病情危重家属放弃治疗,自动出院。结论正确鉴别脑性耗盐综合征和抗利尿激素分泌不适当综合征,是治疗鞍区病变术后低钠血症的关键。试验性补液治疗对诊断及治疗具有重要的价值。

Objectives To explore the types, etiological factor, pathogenesis, diagnosis and treatment strategies of hyponatremia after resection of sella area lesions. Methods The clinical data of 35 patients with hyponatremia after resection of sella area lesions were analyzed retrospectively. The effective treatment methods were summarized through clinical manifestations and laboratory diagnosis. Results Blood volume and serum sodium level of 33 patients returned to the normal level within 3-10 days and discharged and 2 abandoned treatment in critical condition. Conclusions Differential diagnosis between cerebral salt wasting syndrome （CSWS） and syndrome of inappropriate antidiuretic hormone （SIADH） is the key to treat the hyponatremia after sellar surgery. Dignostic fluid replacement therapy has great value in the diagnosis and treatment .