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[垂体后叶素预防性应用对颅咽管瘤术后早期尿崩症及血钠的影响]

[Influence of preventive use of vasopressin tannate on diabetes insipidus and serum sodium at the early postoperation of craniopharyngioma].

作者信息

Xiong Tao, Wanggou Siyi, Li Xuejun, Liu Qing, Jiang Xingjun, Peng Zefeng, Yuan Xianrui

机构信息

Department of Neurosurgery, Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu Zhejiang 322000, China.

Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha 410008, China.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2016 Oct 28;41(10):1058-1063. doi: 10.11817/j.issn.1672-7347.2016.10.008.

Abstract

To explore the influence of preventive use of vasopressin tannate on diabetes insipidus and serum sodium at the early postoperation of craniopharyngioma.
 Methods: The data of 83 patients, who underwent unilateral sub-frontal approach resection of craniopharyngioma between 2010 and 2014 by the same senior neurosurgeon, were retrospectively analyzed. The patients were divided into a vasopressin tannate group (used group) and a control group. The diabetes insipidus and serum sodium changes were compared between the two groups.
 Results: Compared with the control group, the incidence of diabetes insipidus decreased at the early postoperation in the vasopressin tannate group (P<0.05). There was high incidence of diabetes insipidus in patients with pituitary stalk excision and tumor close adhesion to the third ventricle floor at the early postoperation (P<0.05). Under such conditions, the incidence of diabetes insipidus in the vasopressin tannate group was decreased compared with the control group (P<0.05). Postoperative hypernatremia occurred in 37 patients (44.6%), and hyponatremia occurred in 60 patients (72.3%), the average time of the occurrence of hpernatremia and hyponatremia was 1.4 and 3.7 days after surgery. Postoperative high serum sodium and low serum sodium appeared alternately in 19 patients (22.9%). There was significant difference in the serum sodium distribution in the first day after surgery in both groups (P<0.05), and the percent of hpernatremia in the vasopressin tannate group was significantly less than that in the control group (P<0.05).
 Conclusion: Preventive use of vasopressin tannate can effectively reduce diabetes insipidus and hypernatremia incidence at the early postoperative stage after microsurgery for craniopharyngioma.

摘要

探讨垂体后叶素预防性应用对颅咽管瘤术后早期尿崩症及血钠的影响。方法:回顾性分析2010年至2014年期间由同一位资深神经外科医生采用单侧额下入路切除颅咽管瘤的83例患者的资料。将患者分为垂体后叶素组(用药组)和对照组。比较两组患者尿崩症及血钠变化情况。结果:与对照组相比,垂体后叶素组术后早期尿崩症发生率降低(P<0.05)。术后早期垂体柄切除及肿瘤与第三脑室底部紧密粘连的患者尿崩症发生率较高(P<0.05)。在此情况下,垂体后叶素组尿崩症发生率低于对照组(P<0.05)。术后发生高钠血症37例(44.6%),低钠血症60例(72.3%),高钠血症和低钠血症平均发生时间分别为术后1.4天和3.7天。19例患者(22.9%)术后高血钠和低血钠交替出现。两组术后第1天血钠分布有显著差异(P<0.05),垂体后叶素组高钠血症发生率显著低于对照组(P<0.05)。结论:垂体后叶素预防性应用可有效降低颅咽管瘤显微手术后早期尿崩症及高钠血症发生率。

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