Delayed postoperative hyponatremia after endoscopic transsphenoidal surgery for pituitary adenoma
Delayed postoperative hyponatremia after endoscopic transsphenoidal surgery for pituitary adenoma
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DOI：
10.1007/s00701-019-03818-3
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发表时间：
2019-04-01
影响因子：
2.4
通讯作者：
Date, Isao
中科院分区：
文献类型：
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作者：
Tomita, Yusuke;Kurozumi, Kazuhiko;Date, Isao
低钠血症通常发生在经蝶手术（TSS）后的延迟方式。大多数迟发性术后低钠血症（DPH）患者无症状或仅表现非特异性症状;因此，DPH与住院时间延长有关。目前还没有就哪些患者最有可能患上BPH达成共识。我们回顾性分析了2010年1月至2016年12月期间107例接受内镜下TSS治疗垂体腺瘤的连续患者。根据术后第3 - 10天的最低钠水平，对患有DPH（低钠血症组）和未患有DPH（正常钠血症组）的患者进行比较。我们记录了患者的人口统计学资料、临床特征和术后生理特征。结果25例（23.4%）患者在内镜TSS后发生BPH。患者平均年龄54.17岁，63.6%的患者为女性。BPH的总患病率为23.4%。非参数2检验和Mann-Whitney U检验显示，低钠血症组和正常钠血症组在年龄、抗高血压药物使用、无功能垂体腺瘤和术前较高但正常的促甲状腺激素水平方面差异有统计学意义（P
Background Hyponatremia generally occurs after transsphenoidal surgery (TSS) in a delayed fashion. Most patients with delayed postoperative hyponatremia (DPH) are asymptomatic or only express non-specific symptoms; consequently, DPH is associated with prolonged hospitalization. No consensus has been reached on which patients are at greatest risk of developing DPH. We reviewed patients with DPH and evaluated predictive factors for DPH.Methods We retrospectively analyzed 107 consecutive patients who underwent endoscopic TSS for pituitary adenoma (January 2010-December 2016). Patients with DPH (hyponatremia group) and without DPH (normonatremia group) were compared according to their nadir sodium levels on postoperative days 3 to 10. We documented the patients' demographics, clinical features, and postoperative physiological characteristics.Results Twenty-five (23.4%) patients developed DPH after endoscopic TSS. The patients' mean age was 5417years, and 63.6% of the patients were female. The overall prevalence of DPH was 23.4%. The non-parametric 2 test and the Mann-Whitney U test revealed statistically significant differences in age, use of antihypertensive drugs, nonfunctioning pituitary adenoma, and higher yet normal preoperative thyroid-stimulating hormone level between the hyponatremia and normonatremia groups (P