鞍区肿瘤术后急性黏液水肿性昏迷的预防治疗  

Prevention and treatment of myxedema coma complicated with operation on the sellae tumor

作　　者：张小鹏[1] 王伟民[1] 王玉宝[1] 张松柏[1] 林健[1] 

机构地区：[1]中国人民解放军广州军区广州总医院神经外科,广东广州510010

出　　处：《中国微侵袭神经外科杂志》2003年第4期160-162,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的探讨鞍区肿瘤术后并发急性黏液水肿性昏迷的特点,提出术前预防及昏迷抢救治疗方案。方法分析鞍区肿瘤术后并发急性黏液水肿性昏迷病人5例,观察紧急补充大剂量甲状腺激素、糖皮质激素的疗效。观察术前给予甲状腺素片口服预防黏液水肿性昏迷的效果。结果术前甲状腺功能低下未纠正者,术后可以并发急性黏液水肿性昏迷;术前甲状腺功能正常者,因为手术损伤垂体柄、垂体,术后也可以并发急性黏液水肿性昏迷。结论术前甲状腺功能低下者,应补充激素纠正至正常后再手术,可以提高手术的安全性;即使是术前甲状腺功能正常者,术前仍常规给予甲状腺片可以预防因术中损伤垂体、垂体柄导致的甲状腺功能低下性昏迷。Objective To summarize the features of myxedema coma complicated with operations on the sella tumors, and discuss the preoperative prevention and clinic treatment. Methods Analyzed 5 myxedema coma cases. Observed the curative effect by urgent generous supplement of thyroid hormone and the effect of preoperative prevention by taking thyrine. Results The patients whose hypothyroidism were not corrected before operation were easy to occur myxedema coma. Myxedema coma might occur when the patients' pituitary or hypophysial stalk had been harmed during the operation, although the patients' thyroid functions were normal before operation. Conclusion For the operative safety, the hypothyroidism should be redressed by supply thyroid hormone. Giving thyrine before operation even when the patiens' thyroid function was normal, can prevent myxedema coma due to damaging pituitary or hypophysial stalk during the operation.

关 键 词：鞍区肿瘤 术后 急性黏液水肿性昏迷 预防 治疗 

分 类 号：R739.41[医药卫生—肿瘤] R651.1[医药卫生—临床医学]