儿童颅咽管瘤切除术后水钠代谢紊乱的诊断治疗  

Water and serum sodium derangements after pediatric craniopharyngioma resection

作　　者：项炜[1] 朱贤立[1] 赵洪洋[1] 张方成[1] 林洪[1] 林宁[1] 赵甲山[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院神经外科,武汉430022

出　　处：《中华小儿外科杂志》2008年第2期67-69,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的探讨儿童颅咽管瘤切除术后水钠代谢紊乱的原因、诊断和治疗。方法回顾性分析颅咽管瘤切除33例患儿资料，根据临床症状、实验室检查、中心静脉压确定水钠代谢紊乱的类型并进行相应处理。结果术后29例患儿出现尿崩症，出院时13例尿量恢复正常，7例尿量接近正常，9例尿量仍多。24例患儿发生钠代谢紊乱，其中15例低钠血症，3例高钠血症，6例高钠低钠交替。除1例患儿死于癫痫持续状态外，其余23例钠代谢紊乱得到良好纠正。结论处理尿崩症要合理使用抗利尿制剂。引起低钠的原因有脑性盐耗综合征和抗利尿激素异常分泌综合征，脑性盐耗综合征要补液、补盐；抗利尿激素异常分泌综合征要适当限水、利尿。高钠血症要限钠、补液并给予抗利尿制剂。Objective To review the water and serum sodium derangements after resection of pediatric craniopharyngioma. Methods Clinical data of 33 children with craniopharyngioma, who underwent resection, were reviewed. Results Twenty-nine patients developed diabetes insipidus. Of the 29 patients, 13 recovered clinically, 7 improved and 9 still had diabetes insipidus when discharged. Of 24 patients who had sodium derangement, 15 patients suffered from hyponatremia, 3 from hypernatremia and 6 from mixed hypernatremia/hyponatremia. Of these 24 patients, 23 recovered and 1 died of status epilepticus. Conclusions Diabetes insipidus and sodium derangement are common after resection of pediatric craniopharyngioma.

关 键 词：颅咽管瘤 尿崩症 低钠血症 高钠血症 

分 类 号：R739.41[医药卫生—肿瘤] R737.9[医药卫生—临床医学]