内镜下经鼻蝶切除垂体腺瘤术后并发尿崩症相关因素分析

Analysis of related factors of diabetes insipidus after endoscopic transsphenoidal pituitary adenoma resection

目的探讨内镜下经鼻蝶入路切除垂体腺瘤术后发生尿崩症的相关因素。方法回顾性分析2015年6月至2018年9月福建省立医院南院收治的97例内镜下经鼻蝶入路切除垂体腺瘤患者的临床资料,选取性别、年龄、肿瘤大小、肿瘤功能性、肿瘤侵袭性、肿瘤生长类型(是否突破鞍膈)、肿瘤切除程度、手术时长为可能相关因素,采用多因素logistic回归分析术后尿崩症相关因素。结果97例患者中术后尿崩50例,占比51.5%。单因素分析显示,两组的肿瘤生长类型及手术时长比较,差异有统计学意义(P<0.05),将其纳入多因素logistic回归分析显示,鞍上生长型垂体腺瘤是术后发生尿崩症的危险因素(P<0.05)。结论肿瘤生长类型与内镜下经鼻蝶切除垂体腺瘤术后并发尿崩症密切相关,鞍上生长型腺瘤术后尿崩症发生风险高。

Objective To explore the related factors of diabetes insipidus after endoscopic transsphenoidal resection of pituitary adenomas.Methods The clinical data of 97 patients with pituitary adenoma who were treated by endoscopic transsphenoidal surgery in Fujian Provincial South Hospital from June 2015 to September 2018 were retrospectively analyzed.Gender,age,tumor size,tumor function,tumor invasion,tumor growth type(whether to break through the saddle diaphragm),tumor resection degree and operation time were selected as possible related factors.The multivariate logistic regression were used to analyze the related factors of postoperative diabetes insipidus.Results Among the 97 patients,50 cases(51.5%)had postoperative diabetes insipidus.Single factor analysis showed that the difference in tumor growth type and operation duration between the two groups was statistically significant(P<0.05).The multivariate logistic regression analysis showed that suprasellar pituitary adenoma was a risk factor for postoperative diabetes insipidus(P<0.05).Conclusion Tumor growth type is closely related to diabetes insipidus after endoscopic transsphenoidal pituitary adenoma resection,and the risk of diabetes insipidus after suprasellar growth adenoma resection is high.