Rathke囊肿术后并发尿崩症的相关因素分析  

Analysis of factors associated with diabetes insipidus after Rathke cleft cyst surgery

作　　者：吴勇力 陆冬 聂耳 梁君 WU Yongli;LU Dong;NIE Er;LIANG Jun(Graduate School,Xuzhou Medical University,Xuzhou,Jiangsu 221004,China;Department of Neurosurgery,the Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221002)

机构地区：[1]徐州医科大学研究生院,江苏徐州221004 [2]徐州医科大学附属医院神经外科,江苏徐州221002

出　　处：《徐州医科大学学报》2023年第4期248-252,共5页Journal of Xuzhou Medical University

基　　金：国家自然科学基金(81802490)。

摘　　要：目的探讨Rathke囊肿术后并发尿崩症的相关因素。方法选取自2011年1月—2022年1月徐州医科大学附属医院收治的Rathke囊肿患者77例作为研究对象。根据术后是否发生中枢性尿崩症,将患者分为2组:尿崩组(n=35)和非尿崩组(n=42)。比较2组患者主要临床症状、手术方式、手术时间、术中脑脊液漏、囊肿大小分级、囊内容物性状及是否伴囊内出血、囊壁强化情况、囊肿生长类型、囊壁切除程度、复发后二次手术。采用多因素logistic回归分析术后并发中枢性尿崩症的危险因素。结果77例患者术后并发尿崩者35例(45.45%)。单因素分析显示手术方式、囊肿生长类型、囊壁切除程度比较,差异有统计学意义(P<0.05)。多因素logistic分析显示囊壁切除程度、囊肿生长类型是Rathke囊肿术后并发尿崩的独立危险因素。结论囊壁切除程度、囊肿生长类型与Rathke囊肿术后并发尿崩症密切相关。囊壁近全切、鞍内鞍上型及鞍上型术后并发尿崩风险高。Objective To explore the related factors of diabetes insidious after Rathke cleft cyst surgery.Methods A total of 77 patients who were admitted to the Affiliated Hospital of Xuzhou Medical University and diagnosed with Rathke cleft cyst were selected.According to the presence of central diabetes insidious after surgery,the patients were divided into two groups:a diabetes insidious group(n=35)and a non-diabetes insidious group(n=42).Both groups were compared for the main clinical symptoms,surgical methods,operation time,inoperative cerebrovascular fluid leakage,cyst size classification,cyst contents and intracystic hemorrhage,cyst wall enhancement,cyst growth type,the degree of cyst wall resection,and secondary surgery after recurrence.Then,multivariate logistic regression analysis was used to analyze the risk factors of postoperative diabetes insidious.Results There were 35 of 77 patients with diabetes insidious after operation,accounting for 45.45%.According to univariate analysis,there were statistical differences in surgical methods,cyst growth types and the degree of cyst wall resection(P<0.05).Multivariate logistic regression analysis indicated that cyst growth type and the degree of cyst wall resection were the independent risk factors for diabetes insidious after Rathke cleft cyst surgery.Conclusions The degree of cyst wall resection and the type of cyst growth are closely related to diabetes insidious after Rathke cleft cyst surgery.Patients with nearly complete resection of the cyst wall,interstellar suprasegmental type and suprasegmental type have a high risk of diabetes insidious after surgery.

关 键 词：RATHKE囊肿 尿崩症 囊壁 鞍膈 危险因素 

分 类 号：R651.1[医药卫生—外科学]