中国现代神经疾病杂志 ›› 2020, Vol. 20 ›› Issue (4): 289-293. doi: 10.3969/j.issn.1672-6731.2020.04.007

• 小儿神经外科 • 上一篇    下一篇

2 QST分型对儿童颅咽管瘤术后血钠水平异常的影响

梅芬1, 邱若薇2, 刘帆1, 张思琪2, 刘子淼2, 贾淳钰3, 林圳萍3, 包赟1, 漆松涛1, 邱炳辉1   

  1. 1. 510515 广州, 南方医科大学南方医院神经外科;
    2. 510515 广州, 南方医科大学第一临床学院2016级;
    3. 510515 广州, 南方医科大学第一临床学院2017级
  • 收稿日期:2020-03-16 出版日期:2020-04-25 发布日期:2020-04-24
  • 通讯作者: 邱炳辉,Email:13926188251@139.com;包赟,Email:baoyun519@126.com
  • 基金资助:

    广东省教育厅高水平大学建设经费南方医科大学临床研究培育项目（项目编号：LC2016PY012）；广东省教育厅高水平大学建设经费南方医科大学临床研究培育项目（项目编号：LC2019ZD004）；南方医科大学南方医院临床研究专项（项目编号：2018CR029）

The effect of QST classification on serum sodium disorders following removal of craniopharyngioma in children

MEI Fen1, QIU Ruo-wei2, LIU Fan1, ZHANG Si-qi2, LIU Zi-miao2, JIA Chun-yu3, LIN Zhen-ping3, BAO Yun1, QI Song-tao1, QIU Bing-hui1   

  1. 1 Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China;
    2 Grade 2016, the First Clinical Medical College of Southern Medical University, Guangzhou 510515, Guangdong, China;
    3 Grade 2017, the First Clinical Medical College of Southern Medical University, Guangzhou 510515, Guangdong, China
  • Received:2020-03-16 Online:2020-04-25 Published:2020-04-24
  • Supported by:

    This study was supported by Clinical Research Startup Program of Southern Medical University by High-Level University Construction Funding of Guangdong Province Office of Education (No. LC2016PY012, LC2019ZD004) and Clinical Research Program of Nanfang Hospital, Southern Medical University (No. 2018CR029).

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摘要：

目的 探讨不同QST分型颅咽管瘤患儿术后血钠水平异常的发生特点。方法 回顾分析2016年1月至2017年6月经外科手术治疗的48例原发性颅咽管瘤患儿的临床、影像学及手术资料，分析不同QST分型对患儿术后血钠水平的影响及差异性。结果 48例患儿术后发生低钠血症者27例次（56.25%），中至重度12例次占25%；高钠血症32例次（66.67%），中至重度16例次占33.33%。不同分型组患儿低钠血症（χ2=11.420，P=0.003）和高钠血症（χ2=15.702，P=0.000）发生率差异具有统计学意义，其中T型颅咽管瘤患儿术后中至重度低钠血症（Z=-3.324，P=0.001）和中至重度高钠血症（Z=-3.874，P=0.000）发生率高于Q型；单因素Logistic回归分析显示，QST分型是术后发生中至重度血钠水平异常的重要影响因素，T型为其危险因素（OR=315.422，95% CI：16.804~5920.786；P=0.000）。结论 颅咽管瘤患儿术后应进行血钠水平长期监测，QST分型有助于预测血钠水平异常的发生及其严重程度，T型颅咽管瘤患儿可能为术后血钠水平异常的易感者。

关键词: 颅咽管瘤, 儿童, 低钠血症, 高钠血症, 手术后并发症

Abstract:

Objective To investigate the characteristics of serum sodium disorders in children with different QST types of craniopharyngioma (CP). Methods There were 48 children underwent resection of CP from January 2016 to June 2017 were analyzed retrospectively. Statistical methods were used to evaluate the differences in serum sodium disorders among QST classification following removal of CP. Results There were 27 cases (56.25%) had postoperative hyponatremia, including 12 cases (25%) of moderate or severe, and 32 cases (66.67%) of hypernatremia, of which 16 cases (33.33%) were moderate or severe. There were significant differences in incidence of hyponatremia (χ2=11.420, P=0.003) and hypernatremia (χ2=15.702, P=0.000) in children with different QST types of CP. Among them, incidence of moderate-severe hyponatremia (Z=-3.324, P=0.001) and moderate-severe hypernatremia (Z=-3.874, P=0.000) of type T was significantly higher than that of type Q. Logistic regression analysis showed that QST classification was an influential factor for moderate-severe serum sodium disorders after operation, and type T was a risk factor (OR=315.422, 95% CI:16.804-5920.786; P=0.000). Conclusions Long-term monitoring of serum sodium levels is necessity in children after removal of CP. Grasping the QST classification is in favour of comparing and predicting the regularity and severity of postoperatively sodium imbalance. Children with type T CP may be more likely to suffer moderate-severe serum sodium disorders after surgery.

Key words: Craniopharyngioma, Child, Hyponatremia, Hypernatremia, Postoperative complications

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