| 夏浩,吴俊逸,肖耀东,等.神经内镜下垂体腺瘤切除术后迟发性低钠血症的影响因素分析[J].安徽医药,2025,29(2):333-339. |
| 神经内镜下垂体腺瘤切除术后迟发性低钠血症的影响因素分析 |
| Analysis of factors influencing delayed hyponatremia after neuroendoscopic transs-phenoidal surgery for pituitary adenoma |
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| DOI：10.3969/j.issn.1009-6469.2025.02.025 |
| 中文关键词: 垂体肿瘤 迟发性低钠血症 神经内镜手术 影响因素 |
| 英文关键词: Pituitary neoplasms Delayed hyponatremia Neuroendoscopy Influencing factors |
| 基金项目:徐州市医学领军人才培养项目( XWRCHT20210031) |
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| 中文摘要: |
| 目的探讨神经内镜下经鼻蝶垂体腺瘤切除术后迟发性低钠血症的影响因素及治疗。方法回顾性分析自 2020年 1月至 2023年 3月于徐州医科大学附属医院行神经内镜下经鼻蝶入路手术治疗的垂体腺瘤病人 270例，记录临床、实验室以及影像学数据，通过单因素和多因素 logistic分析确定术后迟发性低钠血症的影响因素。结果 270例病人中， 50例出现术后迟发性低钠血症，发生率为 18.5%，发生时间在术后第 5~7天。多因素 logistic回归分析显示，手术前后鞍膈高度变化显著、垂体柄倾斜角度变化程度大、长度变化大、术后未发生尿崩症以及住院时间长的病人发生“可测量垂体柄”术后垂体柄倾斜角度小、迟发性低钠血症的风险更大(P<0.05)。结论手术前后鞍膈高度变化、垂体柄倾斜角度变化和“可测量垂体柄”长度变化在预测神经内镜下垂体腺瘤切除术后迟发性低钠血症起到重要作用。 |
| 英文摘要: |
| Objective To investigate the factors influencing and treatment of delayed hyponatremia after neuroendoscopic transsphe-noidal surgery for pituitary adenoma.Methods A retrospective analysis of 270 patients with pituitary adenoma treated by neuroendo-scopic transsphenoidal surgery at the Affiliated Hospital of Xuzhou Medical University from January 2020 to March 2023 were selectedand clinical, laboratory and imaging data were recorded to determine the factors influencing postoperative delayed hyponatremia by uni-variate and multifactorial logistic analysis.Results Of the 270 patients, 50 developed postoperative delayed hyponatremia, with an in-cidence of 18.5%, occurring between the 5th and 7th postoperative day. Multi-factorial logistic regression analysis showed that patientswith significant preoperative and postoperative changes in saddle diaphragm height, large changes in the angle of tilt of the pituitarystalk, large changes in the length of the "measurable pituitary stalk", small postoperative pituitary stalk tilt, no diabetes insipidus andlong hospital stays were at greater risk of developing delayed hyponatraemia (P<0.05). Conclusion Changes in saddle diaphragmheight, pituitary stalk tilt angle and "measurable pituitary stalk" length before and after surgery play an important role in predicting de-layed hyponatremia after neuroendoscopic transsphenoidal surgery for pituitary adenoma. |
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