神经内镜垂体腺瘤术后延迟性低钠血症的临床研究

Clinical Study of Delayed Hyponatremia after Neuroendoscopic Surgery for Pituitary Adenoma

垂体腺瘤是最常见的鞍部病变,约占颅内肿瘤的10%~15%,在颅内肿瘤中仅次于胶质瘤和脑膜瘤。垂体腺瘤来源于垂体前叶的肿瘤,大部分为良性,极少数为恶性。垂体腺瘤特指起源于垂体前叶的肿瘤,多为良性,极少发生恶变。垂体瘤可通过异常分泌激素及压迫正常的神经组织而影响病人的生活质量及寿命。一般的治疗措施包括手术切除、药物治疗及放射治疗,目前除少数对药物反应良好的垂体瘤患者外,多数患者均需接受外科手术,以彻底切除无功能性腺瘤或控制有功能性腺瘤对激素水平的影响。传统开颅手术因手术时间长,创伤较大,并且容易损伤正常脑组织,目前逐步被经鼻蝶手术取代。然而,经鼻内镜手术通道狭小、操作复杂,患者出现术后并发症风险较高,如脑脊液鼻漏、电解质平衡紊乱、尿崩症及颅内感染等。本文就神经内镜垂体腺瘤的术后出现延迟性低钠血症作一概述。

Pituitary adenoma is the most common saddle lesion, accounting for 10%~15% of intracranial tu-mors, second only to glioma and meningioma in intracranial tumors. Pituitary adenomas originate from tumors in the anterior pituitary, most of which are benign, and a few are malignant. Pituitary adenoma refers to the tumor originating from the anterior pituitary, which is mostly benign and rarely malignant. Pituitary tumors can affect the quality of life and life span of patients through ab-normal hormone secretion and compression of normal nerve tissue. The general treatment measures include surgical resection, drug treatment and radiotherapy. At present, except for a few patients with pituitary adenoma who have good drug response, most patients need to undergo sur-gery to completely remove non-functional adenoma or control the effect of functional adenoma on hormone level. Traditional craniotomy has been gradually replaced by transsphenoidal surgery due to its long operation time, large trauma and easy damage to normal brain tissue. However, due to the narrow channel and complex operation of transnasal endoscopic surgery, patients have a high risk of postoperative complications, such as cerebrospinal fluid rhinorrhea, electrolyte imbalance, diabetes insipidus and intracranial infection. This article summarizes the delayed hyponatremia after neuroendoscopic surgery for pituitary adenoma.