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目的 探讨影响鞍区肿瘤术后水钠失衡的临床因素,为术后及时有效的处理提供经验。方法 对95例鞍区肿瘤手术病例进行回顾性分析。结果 78例（82.1％）出现水钠失衡,其中60例（81.1％）表现为脑性盐耗综合征。术后水钠失衡发生率在恶性肿瘤为100.0％（11/11）,垂体腺瘤91.3％（42/46）,颅咽管瘤75.0％（24/32）,脑膜瘤16.7％（1/6）,不同类型肿瘤间差异显著（P<0.001）。Ⅲ度鞍区肿瘤水钠代谢紊乱发生率为94.7％（34/36）,高于Ⅰ、Ⅱ度肿瘤（P<0.05）。不同手术切除程度的肿瘤,其术后水钠失衡发生率差异不显著（P>0.05）。结论 鞍区肿瘤术后易发生脑性盐耗综合征,水钠失衡的发生率与肿瘤性质及进入第三脑室的程度有关。术后监测尿量、血钠、尿钠变化,及时采取针对性措施可获得良好效果。
Objective To investigate the clinical factors that affect the postoperative water-sodium imbalance in sellar tumors and provide experience for the timely and effective treatment. Methods 95 cases of sellar tumors were retrospectively analyzed. Results 78 cases (82.1%) had water-sodium imbalance, of which 60 (81.1%) showed symptoms of salt-depleted syndrome. The incidence of postoperative water-sodium imbalance in malignant tumors was 100.0% (11/11), pituitary adenomas 91.3% (42/46), craniopharyngioma 75.0% (24/32), meningiomas 16.7% (1/6 ), There was significant difference between different types of tumors (P <0.001). The incidence of water-sodium metabolic disorder was 94.7% (34/36) in grade Ⅲ saddle region, which was higher than grade Ⅰ and grade Ⅱ tumors (P <0.05). There was no significant difference in the incidence of postoperative water-sodium imbalance in tumors with different degrees of resection (P> 0.05). Conclusion The sellar tumor is prone to lead to brain salt consumption syndrome. The incidence of water-sodium imbalance is related to the nature of the tumor and the degree of entering the third ventricle. Postoperative monitoring of urine output, serum sodium, urinary sodium changes in a timely manner to take targeted measures to obtain good results.