解放军医学院学报2017，Vol.38Issue(10)：903-907,5.DOI:10.3969/j.issn.2095-5227.2017.10.001
鞍区占位病变术后伴高钠血症临床特征及预后分析
Clinical features and prognosis of postoperative hypernatremia in patients with space-occupying sellar region lesions
摘要
Abstract
Objective To analyze clinical features and prognosis of postoperative hypernatremia in patients with space-occupying lesions in sellar region.Methods Clinical data about 3 580 patients with sellar region lesions in department of neurosurgery in our hospital from January 2004 to October 2014 were retrospectively analyzed.Hypernatremia was defined as serum sodium greater than or equal to 150 mmol/L.Multivariable logistic regression analysis was used to analyze the contributing factors to the prognosis (death,disturbance of consciousness,and sober).Results The prevalence of hypernatremia in these patients was 5.39％ (n=193) and it occurred mainly in craniopharyngioma (n=116,60.1％),pituitary adenoma (n=31,16.1％),and germ cell tumors (n=11,5.7％).Compared with eunatremia patients (n=200),the mortality in hypernatremia was significantly higher with poor prognosis (4.7％ vs 1.1％,P ＜ 0.05).Compared with the mild hypematremia group (n=56,Na ＜ 160 mmol/L),patients with severe hypernatremia (n=41,Na ≥ 160 mmol/L) had a higher proportion of lesion in the third ventricle (94.6％,P=0.006),longer duration of hypernatremia (9.0 d vs 2.5 d,P=0.000) and lower sodium recovery rate at discharge (46.3％ vs 69.6％,P=0.021).Compared with narrower sodium fluctuation group (fluctuation ＜ 25 mmol/L),patients in wider sodium fluctuation group (fluctuation ≥ 25 mmol/L) had longer hospital stay (P=0.037) and higher incidence of conscious disturbance (P=0.006).Multivariable logistic regression analysis showed that high level of hypematremia,large tumor size,long time of hypernatremia and wide sodium fluctuation were risk factors of poor prognosis.Conclusion Postoperative hypernatremia in patients with space-occupying lesions of the sellar region mainly occurs in craniopharyngioma,pituitary adenoma and germ cell tumors.Patients with lesion in the third ventricle have higher level of hypernatremia.High level of hypernatremia,large tumor size,long course of hypernatremia and wide sodium fluctuation are the independent risk factors of poor prognosis.关键词
高钠血症/鞍区占位病变/外科手术Key words
hypernatremia/sellar region lesions/surgery分类
医药卫生引用本文复制引用
刘昕彤,王敏,王宇,吕波,牟肖艳,周涛,郭清华,母义明..鞍区占位病变术后伴高钠血症临床特征及预后分析[J].解放军医学院学报,2017,38(10):903-907,5.基金项目
国家自然科学基金项目(81270866 （）
81570705) （）
海南省自然科学基金项目(20168353) （20168353）
海南省卫计委资助项目(15A200071) （15A200071）
海南省重大科技项目(ZDKJ2016008) （ZDKJ2016008）
三亚市科技创新项目(2016YW31 （）
2017YW16) （）
解放军总医院扶持基金(2015FC-TSYS-2025) （2015FC-TSYS-2025）
解放军总医院苗圃基金(16KMM43)Supported by the National Natural Science Foundation of China (81270866 （16KMM43）
81570705) （）
the Natural Science Foundation of Hainan Province (20168353) （20168353）
Health and Family Planning Commission Program of Hainan Province (15A200071) （15A200071）
the Major Scientific and Technological Program of Hainan Province (ZDKJ2016008) （ZDKJ2016008）
the Scientific and Technological Innovation Program of Sanya (2016YW31 （）
2017YW16) （）
