经蝶窦垂体腺瘤术后并发尿崩症的临床分析  

Postoperative diabetes insipidus after transsphenoidal resection of pituitary tumor

作　　者：贾涛[1] 文卫平[1] 雷文斌[1] 陈忠平[2] 苏振忠[1] 牟永告[2] 许庚[1] 

机构地区：[1]中山大学附属第一医院耳鼻咽喉科医院,广州510080 [2]中山大学附属肿瘤医院神经外科

出　　处：《中华耳鼻咽喉头颈外科杂志》2007年第3期199-201,共3页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：广东省科技计划项目(2003C32704)

摘　　要：目的探讨经蝶窦垂体腺瘤术后并发尿崩症的预防及处理方法,以减少术后并发症的发生率,提高垂体腺瘤的外科治疗水平。方法回顾性总结近8年收治的86例经蝶窦手术治疗垂体腺瘤患者的临床资料,其中鼻内镜直视下手术35例,鼻内镜下打开蝶窦后显微镜下手术51例,统计分析尿崩症的预防、发生和治疗情况。结果 86例垂体腺瘤患者术后并发尿崩症18例,其中15例为急性尿崩症,3例为迟发性尿崩。15例急性尿崩中一过性尿崩12例(在术后1周内恢复正常);经过临床及时治疗后,14例在1周内恢复正常,4例在2周内恢复正常,无一例持久性尿崩。结论提高手术操作技巧,注意术中保护,避免过度损伤,可以减少尿崩症的发生,而一旦发生尿崩,及时合理使用抗利尿药物与纠正水电解质平衡紊乱是治疗垂体腺瘤术后尿崩症的关键。Objective To study the prevention and treatment of postoperative diabetes insipidus after removal of pituitary tumor through transsphenoidal operation, to decrease the incidence of postoperative complications and improve the treatment of pituitary tumor. Methods The clinical data of 86 cases of transsphenoidal resection of pituitary tumor in recent 8 years were retrospectively reviewed, including 35 endoscopic operation and 51 microscopic operation. The incidence, prevention and treatment of diabetes insipidus were statistically analysed. Results There were 18 cases of postoperative diabetes insipidus in total of 86 operations, including 15 acute cases, 3 delayed cases. Twelve were temporary , which recovered within 1 week. After prompt treatment, 14 recovered within 1 week, 4 recovered within 2 weeks. No persistent diabetes insipidus was found. Conclusions The key points to prevent postoperative diabetes insipidus lay in the improvement of operative skills, careful protection during operation and avoidance of unnecessary injury. In case of diabetes insipidus occurred, rational use of antidiuretics and correction of electrolyte balance were effective in the treatment of postoperative diabetes insipidus.

关 键 词：垂体肿瘤 内窥镜检查 尿崩症 

分 类 号：R736.4[医药卫生—肿瘤]