Yamaki T, Tano-oka A, Takahashi A, Imaizumi T, Suetake K, Hashi K
Department of Neurosurgery, Sapporo Medical College, Japan.
Acta Neurochir (Wien). 1992;115(3-4):156-62. doi: 10.1007/BF01406376.
Two cases with pituitary tumour developed postoperative hyponatraemia which was not caused by inappropriate secretion of antidiuretic hormone. The one case with non-functioning macro-adenoma showed severe hyponatraemia (116 mEq/l) on day 11 after trans-sphenoidal surgery in association with diabetes insipidus (DI). The patients was treated by aqueous pitressin and saline administration to control urinary output and keep positive salt balance at the same time. The other case with GH-producing macro-adenoma showed progressive negative sodium balance with the total loss of 644 mEq resulting in hyponatraemia of 133 mEq/l. This was corrected by additional salt intake. The plasma atrial natriuretic polypeptide (ANP), antidiuretic hormone (ADH) as well as aldosterone levels were normal in the latter case. These patients were considered to manifest primary salt wasting disorder, which should be clearly differentiated from the syndrome of inappropriate secretion of antidiuretic hormone (SIADH).
两例垂体肿瘤患者术后出现低钠血症，并非由抗利尿激素分泌不当所致。一例无功能大腺瘤患者在经蝶窦手术后第11天出现严重低钠血症（116 mEq/l），同时伴有尿崩症（DI）。给予垂体后叶素水剂和生理盐水治疗，以控制尿量并维持正盐平衡。另一例生长激素分泌型大腺瘤患者出现进行性负钠平衡，钠总丢失量达644 mEq，导致血钠水平降至133 mEq/l。通过增加盐摄入得以纠正。后一例患者的血浆心钠素（ANP）、抗利尿激素（ADH）以及醛固酮水平均正常。这些患者被认为表现为原发性盐耗竭紊乱，应与抗利尿激素分泌不当综合征（SIADH）进行明确区分。
