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[颅咽管瘤手术后导致尿崩症的因素分析]

[Analysis of the factors contributing to diabetes insipidus after surgeries for craniopharyngiomas].

作者信息

Luo Shi, Pan Jun, Qi Song-Tao, Fang Lu-Xiong, Fan Jun, Liu Bao-Guo

机构信息

Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.

出版信息

Nan Fang Yi Ke Da Xue Xue Bao. 2009 Mar;29(3):544-7.

Abstract

OBJECTIVE

To analyze the factors contributing to the occurrence of diabetes insipidus after operations for craniopharyngiomas.

METHODS

A total of 121 cases of diabetes insipidus following surgeries for craniopharyngiomas were retrospectively analyzed and the factors associated with postoperative diabetes insipidus were analyzed.

RESULTS

The incidence of diabetes insipidus was 27.3% (33/121 cases) before the operation, 89.9% (107/1119) early after the operation and 39.8%(37/93) in later stages after the operation. The occurrence of early postoperative diabetes insipidus showed a significant relation to the classification and calcification of the craniopharyngioma. Patients with supradiaphragmatic and extraventricular tumors had the lowest incidence of postoperative diabetes insipidus. Late postoperative diabetes insipidus was closely correlated to such factors as age, classification of craniopharyngioma, and intraoperative treatment of the pituitary stalk, but not to the scope of tumor resection or tumor calcification. Late diabetes insipidus was more frequent in children and patients with severed pituitary stalk. The incidence of late postoperative diabetes insipidus was significantly higher in patients with supradiaphragmatic and extra-intraventricular tumors than in those with tumors beneath the diaphragma sellae and extraventricular tumors.

CONCLUSIONS

Postoperative diabetes insipidus following surgeries for craniopharyngiomas is closely related to the tumor classification, calcification and pituitary stalk protection.

摘要

目的

分析颅咽管瘤手术后发生尿崩症的相关因素。

方法

回顾性分析121例颅咽管瘤手术后发生尿崩症的病例,并分析与术后尿崩症相关的因素。

结果

术前尿崩症发生率为27.3%(33/121例),术后早期为89.9%(107/1119),术后晚期为39.8%(37/93)。术后早期尿崩症的发生与颅咽管瘤的分级及钙化显著相关。膈上及脑室外肿瘤患者术后尿崩症发生率最低。术后晚期尿崩症与年龄、颅咽管瘤分级、垂体柄术中处理等因素密切相关,而与肿瘤切除范围或肿瘤钙化无关。儿童及垂体柄离断患者晚期尿崩症更为常见。膈上及脑室内外肿瘤患者术后晚期尿崩症发生率显著高于鞍隔下及脑室外肿瘤患者。

结论

颅咽管瘤手术后尿崩症与肿瘤分级、钙化及垂体柄保护密切相关。

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