91例颅咽管瘤术后并发症及预后分析

The analysis of post-operative complications and prognosis in 91 cases with craniopharyngioma

目的探讨颅咽管瘤术后并发症发病机制及对预后的影响。方法选取中国医科大学附属第一医院2001年1月~2007年12月术后病理明确诊断的颅咽管瘤手术患者91例,统计术后常见并发症及预后不良患者的例数,探讨颅咽管瘤术后主要并发症的发病机制,统计分析其对预后的影响。结果 91例患者中死亡8例,2例患者意识障碍较重,放弃治疗。21例患者术后出现程度不同的意识障碍,61例术后出现尿崩,59例出现水电解质紊乱,53例术后出现发热,4例出现术后癫痫发作。意识障碍与患者预后有相关性（P〈0.01）。结论尿崩、水电解质紊乱、发热、癫痫等是颅咽管瘤术后常见并发症,往往伴有严重的意识障碍,成为影响颅咽管瘤预后的主要因素。

Objective To investigate the pathogenesis of postoperative complications and the impact on the prognosis of craniopharyngioma. Methods 91 patients were confirmed with craniopharyngiomas through pathological analysis in the First Affiliated Hospital of China Medical University from January 2001 to December 2007 were selected,postoperative complications and the impact on the prognosis of craniopharyngioma was statistically analyzed. Results Among 91 patients,there were 8 patients died,2 cases of severe disturbance of consciousness,abandon treatment.There were 21 cases who appeared varying degree of consciousness.61 patients had diabetes insipidus after operation.Water and electrolyte imbalance occured in 59 cases,there were 53 cases of postoperative fever,4 cases of postoperative seizures.Consciousness was correlated with prognosis（P 0.01）. Conclusion Diabetes insipidus,water and electrolyte disorders,fever,and epilepsy are common complications in post-operative craniopharyngioma.Severe disturbance of consciousness after operation play an important role among factors affecting the prognosis of craniopharyngioma resection.