CAJ | 학술논문

目的探讨以低钠血症为首发症状的垂体腺瘤的病因、临床特点及治疗方法. 方法回顾性分析北京协和医院神经外科自2003年1月至2012年12月收治的28例以低钠血症为首发症状的垂体腺瘤患者的临床资料,探讨其病因、临床特点及诊断、治疗方法. 结果本组垂体无功能腺瘤患者27例,泌乳素腺瘤患者1例.垂体大腺瘤患者23例,巨大腺瘤患者5例;经蝶窦入路肿瘤全切除22例,大部切除2例,保守治疗4例;术前合并肾上腺功能减退13例,甲状腺功能减退8例,肾上腺及甲状腺功能均减退5例,抗利尿激素不适当分泌综合征导致低钠血症2例.围手术期及术后经补充激素、限水治疗,低钠血症均得以纠正. 结论以低钠血症起病的垂体腺瘤多为垂体无功能型大腺瘤,手术切除是治疗该病的首选方法,围手术期应纠正低钠血症和垂体前叶功能减退等状态,术后要密切随访.
목적 탐토이저납혈증위수발증상적수체선류적병인、림상특점급치료방법. 방법 회고성분석북경협화의원신경외과자2003년1월지2012년12월수치적28례이저납혈증위수발증상적수체선류환자적림상자료,탐토기병인、림상특점급진단、치료방법. 결과 본조수체무공능선류환자27례,비유소선류환자1례.수체대선류환자23례,거대선류환자5례;경접두입로종류전절제22례,대부절제2례,보수치료4례;술전합병신상선공능감퇴13례,갑상선공능감퇴8례,신상선급갑상선공능균감퇴5례,항이뇨격소불괄당분비종합정도치저납혈증2례.위수술기급술후경보충격소、한수치료,저납혈증균득이규정. 결론 이저납혈증기병적수체선류다위수체무공능형대선류,수술절제시치료해병적수선방법,위수술기응규정저납혈증화수체전협공능감퇴등상태,술후요밀절수방.
Objective To discuss the etiology,clinical features and treatments of patients with pituitary adenomas having onset symptom of hyponatremia.Methods Retrospective analysis was performed on etiology,clinical features and treatment methods of 28 patients with pituitary adenomas having onset symptom ofhyponetramia,admitted to our hospital from Jantary 2003 to December 2012.Results Among 28 patients,27 had non-functional pituitary adenomas and one prolactinoma; 23 had pituitary macroadenomas and 5 giant adenomas; 22 achieved total tumor resection through transsphenoidal approach,2 subtotal removal and 4 received conservative therapy.In total,13 were combined with hypocortisolism,8 with hypothyroidism,5 with both hypocortisolism and hypothyroidism,and 2 with hyponatremia caused by syndrome of inappropriate secretion of antidiuretic hormone in preoperative evaluation.Hyponatremia was corrected by hormone replacement therapy and water limitation during perioperative and postoperative period.Conclusions Pituitary adenomas with onset symptom of hyponatremia are mostly non-functional pituitary macroadenomas.Pituitary adenoma resection is the first-line treatment; hyponatremia and anterior pituitary hypofunction should be corrected in perioperative period,and close postoperative follow-up is necessary.