儿童鞍区肿瘤术后低钠血症的治疗  

Treatment of Postoperative Hyponatremia in Children Associated with Sella Region Tumor

作　　者：贾旺[1] 马振宇[1] 毕智勇[1] 周强[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经外科

出　　处：《首都医科大学学报》2005年第3期303-305,共3页Journal of Capital Medical University

基　　金：国家自然科学基金(30371451)资助项目

摘　　要：目的研究儿童鞍区肿瘤术后低钠血症的发病机制、变化规律及其治疗措施。方法对1997年4月至2002年10月间81例鞍区肿瘤术后并发低钠血症的患儿进行回顾性研究。记录手术当天及术后每天定时检测的血钠值及其相应的治疗措施。结果450例鞍区肿瘤患儿术后81例出现单纯性血钠紊乱,轻度28例(34.6%),中度35例(43.2%),重度18例(22.2%)。其中50.6%(41/81)出现于手术当天和术后第1天。48例(59.3%)有临床症状,26例(32.1%)出现意识障碍。83.9%(68/81)患儿于出现低钠血症后8d内恢复正常。结论儿童鞍区肿瘤术后低钠血症主要原因是抗利尿激素分泌不当综合征(syndromeofinappropriateantidiwetichormonesecretion,SIADH)或脑性耗盐综合征(cerebralsaltwastingsyn-drome,CSWS)。掌握其发病机制可及时有效地纠正低血钠,缩短儿童鞍区肿瘤术后低钠血症的病理经过。Objective To investigate the etiology, regularity and treatment of postoperative hyponatremia of sella region tumor in children.Methods Clinical studies of 81 patients with postoperative hyponatremia of sella region tumor were reviewed retrospectively. Recording serum sodium on the operative day and postoperation daily, corresponding therapy according to the serum sodium and patient's condition was also recorded. Results Purely hyponatremia was observed in 81 of 450 cases. Mild moderate and severe cases hyponatremia were 28(34.6%), 35(43.2%) and 18(22.2%), respectively. 26 cases(32.1%)had disturbance of consciousness. 50.6%(41/81) was occurred on operative day and the first day after operation. 83.9%(68/81) was recovered within 8 d.Conclusion SIADH and CSWS are cardinal etiological factors of hyponatremia in children associated with sella tumor. Grasping the regularity and etiology can redress the sodium irregularity effectively and shorten the pathological process.

关 键 词：鞍区肿瘤术后 低钠血症 儿童 抗利尿激素分泌不当综合征 2002年10月 syndrome 脑性耗盐综合征 发病机制 治疗措施 回顾性研究 1997年 变化规律 术后并发 血钠紊乱 肿瘤患儿 临床症状 意识障碍 salt 出现 血钠值 单纯性 

分 类 号：R473.73[医药卫生—护理学] R591.1[医药卫生—临床医学]