文章摘要
刘玉钊,顾俊怡,李向东,张国东,江熙.鞍内鞍上型颅咽管瘤术后并发重度中枢性尿崩症的 临床分析[J].神经损伤功能重建,2018,13(12):626-629
鞍内鞍上型颅咽管瘤术后并发重度中枢性尿崩症的 临床分析
Clinical Analysis of Severe Central Diabetes Insipidus after Surgery forCraniopharyngioma
  
DOI:
中文关键词: 鞍内鞍上型颅咽管瘤  重度中枢性尿崩症  临床分析
英文关键词: intrasellar-suprasellar craniopharyngioma  central diabetes insipidus  clinical analysis
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作者单位
刘玉钊,顾俊怡,李向东,张国东,江熙 苏州大学附属第一医院神经外科 
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中文摘要:
      目的:探讨鞍内鞍上型颅咽管瘤术后并发重度中枢性尿崩症(CDI)的原因及治疗体会。方法:收集我 院收治的36 例鞍内鞍上型颅咽管瘤术后重度CDI患者的临床资料,回顾性分析肿瘤与三脑室的位置关系、 质地、与周围组织是否粘连3 个不同因素与术后重度CDI发生率的关联,并总结治疗体会。结果:三脑室内 型鞍内鞍上型颅咽管瘤CDI 的发生率高于三脑室外型(P<0.05);与周围解剖结构有粘连的鞍内鞍上型颅 咽管瘤CDI的发生率高于无粘连者(P<0.05);质地软、硬对鞍内鞍上型颅咽管瘤术后重度CDI的发生率无 影响(P>0.05)。经积极治疗短期得到控制者34 例(94.44%),得到控制时间为(9.47±5.87)d,需长期药物控 制尿崩症者2 例(5.56%)。结论:鞍内鞍上型颅咽管瘤位于三脑室内、与周边解剖结构有粘连时术后易发生 重度CDI,与肿瘤质地无明显相关;经积极治疗绝大多数CDI可得到有效控制。
英文摘要:
      To investigate the causes and treatment of severe postoperative central diabetes insipidus (CDI) in patients after surgery for intrasellar-suprasellar craniopharyngioma. Methods: Clinical data were collected of 36 patients treated in our hospital who developed severe CDI after surgery for intrasellar-suprasellar craniopharyngioma. The positional relationship between tumor and three ventricles, tumor texture and whether or not the tumor adheres to surrounding tissues were the main factors to be analyzed. The relationships between the main three key factors and the occurrence of CDI were investigated. The therapeutic experience was summarized. Results: The incidence of postoperative CDI was higher in cases of intraventricular intrasellar-suprasellar craniopharyngioma than in cases of the extraventricular form (P<0.05). Tumors displaying adherence to surrounding tissues showed a higher incidence of postoperative CDI compared to tumors without adherence (P<0.05). Hardness of the tumor showed no significant effect on the incidence of postoperative CDI (P>0.05). After active treatment, 34 cases (94.44%) were controlled in the short term; the control time period was (9.47±5.87) days. Two patients (5.56%) required long-term drug control for diabetes insipidus. Conclusion: Patients with intraventricular intrasellar-suprasellar craniopharyngioma adhering to surrounding tissues are more likely to develop severe CDI after operation; there is no significant correlation between tumor texture and the incidence of postoperative CDI. The majority of severe postoperative CDI cases can be effectively controlled by active treatment.
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