摘要
目的探索术前头部MRI增强扫描和术中垂体柄保留对早期肌注长效抗利尿激素(ADH)治疗早期尿崩和血钠紊乱的指导作用。方法2016年8月~2019年8月,对长沙市第三人民医院脑外科68例颅咽管瘤患者进行了对照试验研究。均分为对照组(常规用药长效ADH)和试验组(根据术前MRI结果调整长效ADH用药频率),每组34例。比较两组患者早期症状(尿崩、头痛头晕、视野障碍、神经内分泌症)和术后血钠情况(低钠、正常、高钠)。结果试验组患者尿崩(17.65%)、头痛头晕(26.47%)、神经内分泌症(5.88%)发生率均低于对照组的(61.76%)、(55.88%)、(7.06%),组间比较差异均有统计学意义(P<0.05)。术后8 d时比较,试验组(91.18%)患者血钠正常率高于对照组(26.47%),而低钠或高钠发生率均低于对照组,两组患者血钠构成情况比较差异有统计学意义(P<0.05)。结论术前头部影像学资料和术中垂体柄保留对早期应用长效ADH治疗颅咽管瘤术后尿崩和血钠紊乱有指导性意义。
Objective To explore the guiding role of preoperative head MRI enhanced scan and intraoperative retention of pituitary stalk for early intrauterine injection of long-acting antidiuretic hormone(ADH)in the treatment of diabetes insidius and hyponatremia disorders.Methods From August 2016 to August 2019,68 patients with craniopharyngioma in the Brain surgery Department of the Third People's Hospital of Changsha city were studied in a controlled trial.All patients were divided into the control group(conventional long-acting ADH)and the experimental group(frequency of long-acting ADH medication was adjusted according to preoperative MRI results),with 34 patients in each group.The early symptoms(diabetes insipidus,headache,dizziness,visual field disorder,neuroendocrine disorder)and postoperative serum sodium(low sodium,normal,high sodium)were compared between the two groups.Results The incidence of diabetes insipidus(17.65%),headache and dizziness(26.47%)and neuroendocrine syndrome(5.88%)in the experimental group were all lower than those in the control group(61.76%),(55.88%)and(7.06%),and the differences between the two groups were statistically significant(P<0.05).At 8 d after surgery,the normal rate of serum sodium in the experimental group(91.18%)was higher than that in the control group(26.47%),while the incidence of low sodium or high sodium was lower than that in the control group.The difference in serum sodium composition between the two groups was statistically significant(P<0.05).Conclusion Preoperative head imaging data and intraoperative retention of pituitary stalk are instructive for the early application of long-acting ADH in the treatment of postoperatie diabetes insipidus and hyponatremia disorders in craniopharyngioma.
作者
李钊
LI Zhao(Changsha Third People's Hospital,Changsha 410000,China)
出处
《中国处方药》
2021年第4期18-20,共3页
Journal of China Prescription Drug
关键词
颅咽管瘤
影像学资料
早期抗利尿激素
尿崩和血钠紊乱
Craniopharyngioma
Imaging data
Early antidiuretic hormone
Diabetes insidius and hyponatremia disorders
