Analysis Of Relevant Factors And Prophylactic Discuss Of Diabetes Insipidus Occurrence After Transsphenoidal Pituitary Adenoma Resection

Objective:To explore the mechanisms as well as diagnosing and treating methods of diabetes insipidus after transsphenoidal resection of pituitary adenomas by analyzing the relevant factors of its occurrence,thus provide prevention and treatment strategies to reduce the incidence of postoperative diabetes insipidus.Methods:We engaged clinical data of 106 patients with pituitary adenoma all of whom were verified by pathological tests and treated by transsphenoidal surgery at The First Affiliated Hospital of Dalian Medical University during June 2016-June 2019 in retrospective analyses to study the relationship between postoperative diabetes insipidus and possible influencing factors.Firstly a single factor analysis was used covering factors including age,gender,endocrine classification,size of tumor,Knosp grades,removal extent of tumor,operation method,direction of tumor growth,presence of CSF leakage.And then we fed the potential ones(p<0.05)into a multivariate binary logistic regression model to define the independent risk factors.Results:Diabetes insipidus occurred with an overall rate of 35.8%(38/106)however no case of permanent existence was found.After single factor analysis,factors including age,gender,endocrine classification,removal extent of tumor,operation method were found no involvement(p>0.05)with the occurrence of postoperative diabetes insipidus while Knosp grades(p=0.019),presence of CSF leakage(p=0.047),size of tumor(p=0.043)and direction of tumor growth(p=0.046)showed statistical difference;then the logistic regression showed that tumor size(W=25.290,P<0.001,OR=25.450,95%CI:7.208～89.852)and presence of sellar breakthrough(W=5.988,P=0.014,OR=10.508,95%CI:1.597 ～69.128)are independent risk factors of postoperative diabetes insipidus occurrence.Conclusion:1.Tumor size and presence of sellar breakthrough are independent risk factors of diabetes insipidus occurrence after transsphenoidal pituitary adenoma resection.2.Properly evaluating tumor size and whether there is sellar breakthrough or not before surgery,as well as strengthening intraoperative protection of pituitary stalk,hypothalamus and posterior tissue would effectively prevent the occurrence of postoperative diabetes insipidus.