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

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