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目的探讨儿童颅咽管瘤术后血清TSH、皮质醇及血Na+浓度对认知功能的影响。方法分析2013年1月至2014年6月在我院接受治疗的31例颅咽管瘤术后认知障碍的儿童的临床资料,并列为观察组,选取25例在我院进行健康检查的儿童作为对照组。结果观察组患者在延迟回忆(t=4.578,P<0.001)、注意力及计算能力(t=3.762,P<0.001)、MMSE总分(t=10.56,P<0.001)水平上显著低于对照组,差异具有统计学意义(P<0.05)。两组研究对象在定向能力(t=1.687,P=0.097)、即刻回忆(t=1.455,P=0.151)及语言能力水平(t=1.089,P=0.281)上不存在统计学差异(P>0.05);观察组患者术后TSH、皮质醇明显低于对照组,差异具有统计学差异(P<0.05),观察组患者血Na+浓度明显高于对照组,差异具有统计学差异(P<0.05)。观察组患者术前、术后TSH、皮质醇水平明显低于对照组,差异具有统计学差异(P<0.05);采用Pearson相关性检验分析观察组患者血清中TSH、皮质醇、血Na+浓度与MMSE相关性,结果显示观察组患者TSH与MMSE(r=0.453,P=0.011)及皮质醇(r=0.498,P<0.001)呈现显著正相关,血清中血Na+浓度与MMSE呈现负相关(r=-0.383,P=0.033)。结论颅咽管瘤翼点入路术后血清TSH、皮质醇下降及血Na+浓度的升高可能对患儿认知功能产生一定的损伤。
Objective To investigate the effect of serum TSH, cortisol and blood Na + concentration on cognitive function in children with craniopharyngioma. Methods The clinical data of 31 children with cognitive dysfunction after craniopharyngioma surgery from January 2013 to June 2014 in our hospital were analyzed and included in the observation group. Twenty-five children undergoing physical examination in our hospital As a control group. Results In observation group, the scores of MMSE (t = 4.578, P <0.001), attention and calculation ability (t = 3.762, P <0.001) Group, the difference was statistically significant (P <0.05). There was no significant difference between the two groups in orientation ability (t = 1.687, P = 0.097), immediate memory (t = 1.455, P = 0.151) and language proficiency (t = 1.089, P = 0.281) 0.05). The postoperative TSH and cortisol levels in the observation group were significantly lower than those in the control group (P <0.05). The blood Na + concentration in the observation group was significantly higher than that in the control group (P <0.05) ). The levels of TSH and cortisol in the observation group were significantly lower than those in the control group before and after surgery (P <0.05). The Pearson correlation test was used to analyze the levels of TSH, cortisol and blood Na + in the observation group MMSE, the results showed that there was a significant positive correlation between TSH and MMSE (r = 0.453, P = 0.011) and cortisol (r = 0.498, P <0.001) = -0.383, P = 0.033). Conclusion The elevation of serum TSH, cortisol and blood Na + concentration after craniopharyngioma pterional approach may cause certain damage to children’s cognitive function.