Clinical Analysis Of Electrolytes And Cortisol Hormone Changes After Cerebral Tumor Surgery

Objective To analyze the electrolyte after brain tumor surgery for five days, especially the change of serum sodium, cortisol and ACTH, discuss the incidence of hyponatremia, the severity of hyponatremia and the correlation with tumor type, surgical approach and age.Method To retrospective analyzed the data of patients with cerebral tumor who admitted to the Central South University of XiangYa Hospital neurosurgery in May2010to January2012.242cases had done the preoperative and postoperative electrolyte and cortisol testing. Preoperative serum sodium monitoring was all normal, the cortisol and ACTH within the normal range. Monitoring electrolyte in the postoperative1-5days continuously. Monitoring serum cortisol and ACTH before used any cortisol drug. Every patient should note the24hours urine volume and the fluid replacement way after operation. In some postoperative hyponatremia cases, central venous pressure determination was used to guide the treatment.Result119cases were diagnosed of postoperative hyponatremia in242cases of patients with brain tumor, accounting for49.17%of the total number of people. The type of cerebral tumor, surgical procedure and age produced an effect on the occurrence of postoperative hyponatremia, but not the severity of hyponatremia. There was no significant difference between the several types of cerebral tumor in the peak time of postoperative hyponatremia, about in the3.88±1.116th day after operation. The occurrence of postoperative cortical dysfunction was59.4%. The cerebral tumor type can influence the postoperative cortex dysfunction. The incidence of cortical dysfunction for craniotomy(68.30%) is higher than nose sellar tumor resection(52.00%), but no statistical significance(P=0.058). The reason is lack of sample size.Conclusion Hyponatremia and cortical dysfunction are easily happened after cerebral tumor surgery. The patients with craniophary-ngioma who are younger than20years old used craniotomy are more likely to get hyponatremia. The patients with different ages using the different surgical methods to treat the different types of cerebral tumor, the severity of hyponatremia is consistent. Some cases of hyponatremia is SIADH and CSWS, according to the postoperative blood volume and the balance of sodium metabolism to identify. If it is SIADH, limit the amount of liquid intake to treat this condition. Add volume and sodium can correct CSWS. The craniotomy is more likely to cause cortical dysfunction, but there is no statistical significance. The treatment is ACTH or exogenous glucocorticoid.