中国现代神经疾病杂志 ›› 2024, Vol. 24 ›› Issue (4): 280-284. doi: 10.3969/j.issn.1672-6731.2024.04.013

• 综述 • 上一篇    下一篇

2 经蝶窦鞍区病变手术后迟发性低钠血症

刘玉晓1, 姚勇2,*(), 张毅2,*()   

  1. 1. 100730 中国医学科学院 北京协和医学院临床医学专业试点班
    2. 100730 中国医学科学院 北京协和医学院 北京协和医院神经外科
  • 收稿日期:2024-02-26 出版日期:2024-04-25 发布日期:2024-05-06
  • 通讯作者: 姚勇, 张毅
  • 基金资助:
    北京协和医院中央高水平医院临床科研专项(2022-PUMCH-B-114)

Delayed hyponatremia after transsphenoidal surgery

Yu-xiao LIU1, Yong YAO2,*(), Yi ZHANG2,*()   

  1. 1. 4+4 Medical Doctor Program, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
    2. Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
  • Received:2024-02-26 Online:2024-04-25 Published:2024-05-06
  • Contact: Yong YAO, Yi ZHANG
  • Supported by:
    National High Level Hospital Clinical Research Funding of Peking Union Medical College Hospital(2022-PUMCH-B-114)

摘要:

术后迟发性低钠血症是经蝶窦手术的常见内分泌相关并发症,是最常见的再入院原因,通常发生于术后5~7 d。轻度和中度患者可无症状,也可表现为恶心、呕吐、头痛等;重度患者可出现严重神经精神症状、脑水肿甚至死亡。术后迟发性低钠血症危险因素众多且复杂,目前尚缺乏预防和监测标准。本文从经蝶窦鞍区病变手术后迟发性低钠血症的发生机制、人群特点、监测与诊断、预防与处理等方面进行综述,为临床实践提供依据。

关键词: 低钠血症, 手术后并发症, 蝶鞍, 综述

Abstract:

Delayed hyponatremia is a common endocrinologic complication after transsphenoidal surgery, also the most frequent cause of hospital readmissions post surgery. It usually occurs in the 5th to 7th day post operation. Patients can present without symptoms when they encounter mild or moderate hyponatremia, sometimes presenting symptoms such as nausea, headache and vomiting, etc.. In patients with severe hyponatremia, neuropsychiatric symptoms, cerebral edema and even death can occur. The risk factors related to this condition is various and complicated, and yet lack of standard procedures for prevention and monitoring. This article aims to provide a review of the literatures regarding pathophysiology, patient characteristics, monitoring and diagnosis, prevention and intervention of delayed hyponatremia after transsphenoidal surgery, thus enhancing acknowledgement on this condition and providing evidence for clinical practice.

Key words: Hyponatremia, Postoperative complications, Sella turcica, Review