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目的:总结巨大垂体腺瘤水钠代谢紊乱的围手术期处理经验。方法:对71例巨大垂体腺瘤患者术前及术后1周内每日检测血、尿电解质水平,以及血、尿渗透压,判断失钠及失水类型。总结不同瘤体大小与手术入路和水钠紊乱发生率、程度、时间之间的关系。结果:71例巨大垂体腺瘤患者中,出现水钠代谢紊乱52例,发生率73.2%。肿瘤大小与水钠紊乱发生率、严重程度、发生时间成正比,而手术入路选择与水钠代谢紊乱发生无明显相关。结论:巨大垂体腺瘤患者术后水钠代谢紊乱的发生与瘤体大小成正相关,其出现时间和表现形式复杂。对水钠代谢紊乱严重患者可适当予以预防性治疗,以减少临床症状和不良后果。
Objective: To summarize the experience of perioperative management of the disorder of water-sodium metabolism in giant pituitary adenoma. Methods: 71 patients with giant pituitary adenoma were examined daily for blood and urine electrolytes, blood and urine osmotic pressure before operation and within 1 week after operation, and the type of sodium loss and water loss were determined. Summarizes the different tumor size and surgical approach and the incidence of sodium and water disorders, the extent of the relationship between the time. Results: Among 71 patients with giant pituitary adenoma, 52 cases of water-sodium metabolism disorder occurred, the incidence rate was 73.2%. Tumor size and the incidence of sodium and water disorders, the severity of the time is proportional to the choice of surgical approach and sodium and sodium metabolism disorder was not significantly correlated. Conclusion: The incidence of postoperative water-sodium metabolism disorders in patients with huge pituitary adenoma is positively correlated with the size of the tumor, and its appearance time and manifestation are complex. Of sodium and metabolic disorders in patients with severe water may be prophylactically treated to reduce clinical symptoms and adverse consequences.