颅咽管瘤患儿围手术期三相性尿崩继发脑桥中央髓鞘溶解症1例并文献复习  

Case of Central Pontine Myelinolysis Secondary to Perioperative Triphasic Diabetes Insipidus in Children with Craniopharyngioma and Literature Review

作　　者：罗杰 姚辉 杜婷婷 LUO Jie;YAO Hui;DU Tingting(School of Medicine,Jianghan University,Wuhan 430056,Hubei,China;Department of Endocrinology and Genetic Metabolism,Wuhan Children's Hospital,Wuhan 430016,Hubei,China)

机构地区：[1]江汉大学医学部,湖北武汉430056 [2]武汉儿童医院遗传代谢内分泌科,湖北武汉430016

出　　处：《江汉大学学报（自然科学版）》2023年第3期82-86,共5页Journal of Jianghan University：Natural Science Edition

基　　金：中华国际医学交流基金会项目(Z-2019-41-2101-01)。

摘　　要：目的脑桥中央髓鞘溶解症(central pontinemyelinolysis,CPM)为罕见的神经脱髓鞘性疾病,为掌握该病的临床特征,结合相关文献复习以提高对该病的认识。方法对所收治的1例CPM患儿临床资料进行分析,并结合相关文献对CPM的病因、发病机制、诊治及预后进行回顾性综述。结果本例患儿术后因下丘脑损伤出现三相性尿崩,在由低钠血症期过渡至长期尿崩期时,患儿血钠浓度升高过快导致CPM发生。结论对于术后出现三相性尿崩的颅咽管瘤患儿,在围手术期及时动态监测血钠浓度对预防CPM发生具有重要意义。Objective Central pontine myelinolysis(CPM)is a rare demyelinating disease.This study aims to grasp the clinical manisfestations of the disease and review the relevant literature to improve the clinicians'understanding of the disease.Methods We analyzed the clinical data of a child with CPM and retrospective reviewed the etiology,pathogenesis,diagnosis,treatment,and prognosis of CPM combined with relevant articles.Results The child with craniopharyngioma was diagnosed with triphasic diabetes insipidus after the operation.During the transition from the hyponatremia stage to the long-term diabetes insipidus stage,the rapid increase of blood sodium concentration eventually led to CPM.Conclusion For children with craniopharyngioma who have developed triphasic diabetes insipidus,dynamic monitoring of serum sodium concentration during the perioperative period is significant to prevent CPM.

关 键 词：颅咽管瘤 儿童 三相性尿崩 脑桥中央髓鞘溶解症 

分 类 号：R726[医药卫生—儿科] R744.5[医药卫生—临床医学] R739.4