Zhou Zhong-qing, Shi Xiang-en
Department of Neurosurgery, Peking University People's Hospital, Beijing 100044, China.
Chin Med J (Engl). 2004 Mar;117(3):357-60.
This paper aimed to elucidate the changes of hypothalamus-pituitary hormones in patients after total removal of craniopharyngiomas.
A total of 40 patients with craniopharyngiomas received surgery. The levels of triiodothyronine (T3), thyroxine (T4), thyrotropic hormone (TSH), antidiuretic hormone (ADH), and adrenocorticotropin (ACTH) were measured in the 40 patients before surgery and one week after surgery respectively.
Twenty-eight patients (70%) had hypothyroidism before surgery, but 38 (95%) had hypothyroidism after surgery (P < 0.01). Twenty-three patients (57.5%) had diabetes insipidus (DI) before surgery and 38 (95%) had DI after surgery (P < 0.001). The pre- and post-operative levels of ADH were (2.49 +/- 0.30) pg/ml and (2.80 +/- 0.29) pg/ml respectively (P > 0.05), whereas those of ACTH were (23.97 +/- 2.69) pg/ml and (15.60 +/- 1.91) pg/ml respectively (P < 0.05).
Hormone deficits after total removal of craniopharyngioma appear to be the common complication of surgery. Hypothyroidism and diabetes insipidus are more frequent after surgery than before surgery. Thyroxine and glucocorticoids should be administered routinely after total removal of craniopharyngioma.
本文旨在阐明颅咽管瘤全切术后患者下丘脑 - 垂体激素的变化。
共有40例颅咽管瘤患者接受了手术。分别在这40例患者术前及术后1周测定三碘甲状腺原氨酸（T3）、甲状腺素（T4）、促甲状腺激素（TSH）、抗利尿激素（ADH）及促肾上腺皮质激素（ACTH）水平。
术前28例患者（70%）存在甲状腺功能减退，而术后有38例（95%）出现甲状腺功能减退（P < 0.01）。术前23例患者（57.5%）患有尿崩症（DI），术后有38例（95%）患有DI（P < 0.001）。ADH术前及术后水平分别为（2.49 ± 0.30）pg/ml和（2.80 ± 0.29）pg/ml（P > 0.05），而ACTH术前及术后水平分别为（23.97 ± 2.69）pg/ml和（15.60 ± 1.91）pg/ml（P < 0.05）。
颅咽管瘤全切术后激素缺乏似乎是手术的常见并发症。术后甲状腺功能减退和尿崩症比术前更常见。颅咽管瘤全切术后应常规给予甲状腺素和糖皮质激素。
