[1]黄涛,王宝,田启龙,等.儿童颅咽管瘤术后水电解质紊乱的管理方案[J].中国临床神经外科杂志,2022,27(05):360-362.[doi:10.13798/j.issn.1009-153X.2022.05.008]
　HUANG Tao,WANG Bao,TIAN Qi-long,et al.Management of water and electrolyte disturbances in children with craniopharyngioma after surgery[J].,2022,27(05):360-362.[doi:10.13798/j.issn.1009-153X.2022.05.008]
点击复制

儿童颅咽管瘤术后水电解质紊乱的管理方案()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
27
期数:
2022年05期
页码:
360-362
栏目:
论著
出版日期:
2022-05-31

文章信息/Info

Title:
Management of water and electrolyte disturbances in children with craniopharyngioma after surgery
文章编号:
1009-153X(2022)05-0360-03
作者:
黄涛; 王宝; 田启龙; 王樑; 屈延; 王举磊
710038西安，中国人民解放军空军军医大学唐都医院神经外科（黄涛、王宝、田启龙、王樑、屈延、王举磊）
Author(s):
HUANG Tao;  WANG Bao;  TIAN Qi-long;  WANG Liang;  QU Yan;  WANG Ju-lei
Department of Neurosurgery, Tangdu Hospital, Air Force Military Medical University, Xi'an 710038, China
关键词:
颅咽管瘤; 儿童; 显微手术; 尿崩症; 电解质紊乱
Keywords:
Craniopharyngioma;  Microsurgery;  Children;  Diabetesinsipidus;  Electrolyte disorder
分类号:
R739.41;R651.1+1
DOI:
10.13798/j.issn.1009-153X.2022.05.008
文献标志码:
A
摘要:
目的 探讨儿童颅咽管瘤术后水电解质紊乱的管理方案。方法 回顾性分析2016年12月到2019年5月手术治疗的56例儿童颅咽管瘤的临床资料。术后高钠血症使用生理盐水补充每日钠需要量+5%葡萄糖溶液降血钠，术后出现重度低钠血症使用3%盐水微量泵持续补钠。结果 术后出现尿崩症40例（71.4%），电解质紊乱30例（53.6%）。高钠血症患儿治疗第一天血钠波动幅度平均为（7.8±2.0） mmol/L，第二天平均为（5.9±2.2） mmol/L，控制时间平均（76.5±11.7）h。重度低钠血症患儿治疗第一天波动幅度平均为（7.7±2.0） mmol/L，第二天平均为（7.5±3.1） mmol/L，控制时间平均（89.8±14.2）h。治疗过程中，未出现意识障碍、癫痫、脱髓鞘等并发症。出院时，40例尿崩症患儿的尿量得到控制，30例电解质紊乱患儿连续3次血清Na+正常。结论 儿童颅咽管瘤术后电解质紊乱发生率高，稳定血清钠波动幅度，有助于改善病人预后。
Abstract:
Objective To explore the management of water and electrolyte disturbances in children with craniopharyngioma after operation. Methods The clinical data of 56 children with craniopharyngioma who underwent surgery from December 2016 to May 2019 were retrospectively analyzed. For postoperative hypernatremia, 0.9% normal saline was used to supplement daily sodium requirement and 5% glucose solution was used to reduce serum sodium. For postoperative severe hyponatremia, 3% sodium chloride solution was used to supplement the serum sodium. Results Diabetes insipidus occurred in 40 patients (71.4%) and electrolyte disturbance in 30 (53.6%) after operation. In children with hypernatremia, The mean fluctuation range of serum sodium was (7.8±2.0) mmol/L at first day of the treatment and (5.9±2.2) mmol/L at the second day, and the average control time of serum sodium was (76.5±11.7) h. In in children with hyponatremia, the mean fluctuate range of serum sodium was (7.7±2.0) mmol/L at first day of the treatment and (7.5±3.1) mmol/L at the second day, and the average control time of serum sodium was (89.8±14.2) h. Conclusions The incidence of electrolyte disturbance is high in the children with craniopharyngioma after surgery. The prognosis of patients can be significantly improved by stabilizing the fluctuation range of serum sodium.

参考文献/References:

[1] Vinchon M, Weill J, Delestret I, et al. Craniopharyngioma and hypothalamic obesity in children [J]. Childs Nerv Syst, 2009, 25(3): 347-352.
[2] 程　荆，江普查，曹长军，等. 颅咽管瘤显微手术的疗效分 析[J]. 中国临床神经外科杂志，2016，21（1）：1-3.
[3] 漆松涛，潘　军，包　贇，等. 颅咽管瘤的QST分型特点 和手术治疗[J]. 中华神经外科杂志，2017，33（11）：1088- 1093.
[4] Edate S, Albanese A. Management of electrolyte and fluid disorders after brain surgery for pituitary/suprasellar tumours [J]. Horm Res Paediatr, 2015, 83(5): 293-301.
[5] Guideline: Potassium Intake for Adults and Children [M]. Geneva: World Health Organization, 2012.
[6] 赵继宗. 神经外科手册[M]. 第8版. 南京：江苏凤凰科学 技术出版社. 2017. 74-79.
[7] 颅咽管瘤围手术期管理中国专家共识（2017）[J]. 中华医 学杂志，2018，98（1）：5-10.
[8] Bao Y, Pan J, Qi ST, et al. Origin of craniopharyngiomas: implications for growth pattern, clinical characteristics, and outcomes of tumor recurrence [J]. J Neurosurg, 2016, 125 (1): 24-32.
[9] Müller HL. Craniopharyngioma [J]. Endocr Rev, 2014, 35 (3): 513-543.
[10] Loh JA, Verbalis JG. Diabetes insipidus as a complication after pituitary surgery [J]. Nat Clin Pract Endocrinol Metab, 2007, 3(6): 489-494.
[11] Jane JA Jr, Vance ML, Laws ER. Neurogenic diabetes insi- pidus [J]. Pituitary, 2006, 9(4): 327-329.
[12] Dabadghao P. Craniopharyngiomas: Postoperative assess- ment of fluid and electrolyte disturbances [J]. Neurol India, 2015, 63(5): 663-664.
[13] 王洪伟，张剑宁，于　新，等. 颅咽管瘤的个体化治疗分析 [J]. 中国临床神经外科杂志，2016，21（3）：141-144.

相似文献/References:

[1]吴　亮　黄　玮　余永佳　利文倩　陆　健　林正锋.儿童低级别脑动静脉畸形的治疗[J].中国临床神经外科杂志,2016,(05):294.[doi:10.13798/j.issn.1009-153X.2016.05.012]
[2]葛怡宁　幸　兵　姚　勇　邓　侃　王任直.颅咽管瘤合并毛细胞星形细胞瘤1例[J].中国临床神经外科杂志,2016,(05):319.[doi:10.13798/j.issn.1009-153X.2016.05.023]
[3]郭宏伟　高玉松　罗新民　张松坡　胡承啸　扈俊华　柴　超　雷亚萍.儿童弥漫轴索损伤早期诊断与治疗[J].中国临床神经外科杂志,2016,(06):368.[doi:10.13798/j.issn.1009-153X.2016.06.016]
[4]王洪伟　张剑宁　于　新　王亚明　李海龙　韩铖琛　杨　帆.颅咽管瘤的个体化治疗分析[J].中国临床神经外科杂志,2016,(03):141.[doi:10.13798/j.issn.1009-153X.2016.03.003]
　WANG Hong-wei,ZHANG Jian-ning,YU Xin,et al.Individualized treatment for craniopharyngiomas and analyses of typical cases[J].,2016,(05):141.[doi:10.13798/j.issn.1009-153X.2016.03.003]
[5]刘　巍　宫　剑　马振宇　李春德.经纵裂-胼胝体-穹窿间入路显微手术治疗儿童中脑海绵状血管瘤[J].中国临床神经外科杂志,2016,(02):65.[doi:10.13798/j.issn.1009-153X.2016.02.001]
　LIU Wei,GONG Jian,MA Zhen-Yu,et al.Surgery via transcallosal anterior interforniceal approach for midbrain cavernous malformations in children (report of 7 cases)[J].,2016,(05):65.[doi:10.13798/j.issn.1009-153X.2016.02.001]
[6]程 荆　江普查　曹长军　李登辉　黄　充　游　金　兰　静.颅咽管瘤显微手术的疗效分析[J].中国临床神经外科杂志,2016,(01):1.[doi:10.13798/j.issn.1009-153X.2016.01.001]
　CHENG Jing,JIANG Pu-cha,CAO Chang-jun,et al.Analysis of curative effect of microsurgery on craniopharyngiomas (report of 126 cases)[J].,2016,(05):1.[doi:10.13798/j.issn.1009-153X.2016.01.001]
[7]孙　涛　王德江　万伟庆　宫　剑　李春德.儿童视路胶质瘤3例报告并文献复习[J].中国临床神经外科杂志,2016,(01):44.[doi:10.13798/j.issn.1009-153X.2016.01.016]
[8]杨朋范　梅　珍　张辉建　裴家生　林　巧　贾延增　钟忠辉.颞顶枕离断术治疗儿童单侧多脑叶难治性癫痫[J].中国临床神经外科杂志,2015,(10):605.[doi:10.13798/j.issn.1009-153X.2015.10.009]
　YANG Peng-fan,MEI Zhen,ZHANG Hui-jian,et al.Disconnective surgery for unilateral posterior quadrantic epilepsy: a series of 17 paediatric patients[J].,2015,(05):605.[doi:10.13798/j.issn.1009-153X.2015.10.009]
[9]项　炜　何运松　朱贤立　赵洪洋　张方成　林　洪　林　宁　林敏华.216例颅咽管瘤的显微手术治疗[J].中国临床神经外科杂志,2015,(04):205.[doi:10.13798/j.issn.1009-153X.2015.04.004]
　XIANG Wei,HE Yun-song,ZHU Xian-li,et al.Microsurgery for craniopharyngiomas (report of 216 cases)[J].,2015,(05):205.[doi:10.13798/j.issn.1009-153X.2015.04.004]
[10]潘军红　顾晶晶　栾国明.整体护理对大脑半球切除术后Rasmussen脑炎儿童生活质量的影响[J].中国临床神经外科杂志,2015,(03):179.[doi:10.13798/j.issn.1009-153X.2015.03.019]

备注/Memo

备注/Memo:
通讯作者：王举磊，E-mail：wangjulei@163.com
更新日期/Last Update: 2022-06-30