Peng Li-Lei, Dong Wei, Zhou Pei-Zhi, Ma Wei-Chao, Li You-Ping, Wu Qian, Jiang Shu
Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2013 May;44(3):444-7.
To determine the value of urine volume and urine electrolytes in postoperative management of patients with sellar tumors.
Medical records of 103 patients with sellar tumors in the West China Hospital from January 2009 to December 2009 were retrospectively reviewed. The patients were managed either based on blood electrolytes (Group A, n = 56) or based on urine volume and urine electrolytes (Group B, n = 47). The incidence of balance disturbance of water and electrolytes was compared between the two groups.
The levels of blood electrolytes were normal in both groups 3 days after operations despite significant loss of electrolytes through urine. Balance disturbance of water and electrolytes was revealed 4-7 days after operations. Group B had a lower incidence of balance disturbance of water and electrolytes (17.02%, 8/47) compared with Group A (73.21%, 41/56, P < 0.05). No gender difference in the incidence of balance disturbance of water and electrolytes was found. Higher incidence of balance disturbance of water and electrolytes was found in craniopharyngioma (P < 0.05, vs. pituitary adenoma) and in the patients undergoing craniotomy (P < 0.05, vs. transsphenoidal approach) in Group A, but not in Group B.
Better management of balance disturbance of water and electrolytes can be achieved for patients with sellar tumors through monitoring urine than through blood. It can also simplify the postoperative management of patients with sellar tumors.
确定尿量和尿电解质在鞍区肿瘤患者术后管理中的价值。
回顾性分析2009年1月至2009年12月在华西医院接受治疗的103例鞍区肿瘤患者的病历。患者分为两组,A组(n = 56)根据血电解质进行管理,B组(n = 47)根据尿量和尿电解质进行管理。比较两组水电解质平衡紊乱的发生率。
尽管术后经尿液有大量电解质丢失,但两组术后3天血电解质水平均正常。术后4 - 7天出现水电解质平衡紊乱。与A组(73.21%,41/56)相比,B组水电解质平衡紊乱的发生率较低(17.02%,8/47,P < 0.05)。未发现水电解质平衡紊乱发生率存在性别差异。A组中颅咽管瘤患者(与垂体腺瘤相比,P < 0.05)及接受开颅手术的患者(与经蝶窦入路相比,P < 0.05)水电解质平衡紊乱的发生率较高,但B组未出现此情况。
对于鞍区肿瘤患者,通过监测尿液比监测血液能更好地管理水电解质平衡紊乱,还可简化鞍区肿瘤患者的术后管理。