Clinical Analysis Of The Factors Contributing To Blood Sodium Disorders After Craniopharyngioma Resection

Objective:This article analyzes the relationship between sodium disorders in patients with postoperative incidence of craniopharyngioma, sodium disorder types and related factors, and explore factors craniopharyngioma occurrence and postoperative hyponatremia disorders.Materials and Methods:A retrospective analysis of Shandong Provincial Hospital in January2008-June2013were diagnosed parallel micro-surgery treatment of168cases of patients with craniopharyngioma clinical medical records, patient age, gender, tumor size, tumor image credit type, tumor calcification, surgical approach, intraoperative pituitary stalk retained former case, the extent of tumor resection, intraoperative or without diabetes insipidus, the relationship between sodium and sodium disorders and endocrine disorders among disorders conducted by statistical methods analysis.Results:The study of168cases, including88cases of male patients;80cases of female patients,38cases of underage patients,138cases of adult patients;28cases of small (<2cm),90cases of medium-(2-4cm),42cases of large-scale (4-6cm),8cases of giant (>6cm);126cases of the diaphragm,18cases of below the diaphragm,8cases of third ventricle in,16cases of three brain indoor and outdoor mixed;102cases of chunks of calcification,66cases of smaller or no calcification calcification in;8cases of inferior frontal approach,102cases of pterion Road,54cases of forehead interhemispheric approach in, four cases of the frontal corpus callosum-septum-approach between the dome; preoperative22cases of diabetes insipidus patients before surgery,88cases of endocrine disorders which occurred before surgery;112cases of expressly reserves the pituitary stalk,56cases patients who did not expressly reserves the pituitary stalk; resection, subtotal104cases,64cases of subtotal sodium disorders occur in16patients (9.5%), postoperative hyponatremia disorders were96cases (57.1%), significantly increased the incidence of postoperative compared with preoperative. Postoperative hyponatremia disorders associated with age, gender, tumor imaging classification, surgical approach, intraoperative endocrine disorders are not related (P>0.05), with or without preoperative diabetes insipidus, preoperative presence of potassium disorders, cancer degree of calcification, pituitary stalk reserved cases, the extent of tumor resection, tumor size (P<0.05), serum sodium disorder type and the patient’s age, sex, tumor size, tumor imaging classification, tumor calcification, surgical approach, pituitary surgery handle reservations, the tumor resection haven no relationship.Conclusion:1.The incidence of postoperative craniopharyngioma a sodium imbalance is very high, is one of the common complications craniopharyngioma surgery, this group of patients was57.1%, and a lower incidence of postoperative hyponatremia disorder surgery former significantly increased, this has a statistical significance;2. Patients with hyponatremia after craniopharyngioma disorder incidence is unrelated with age, gender, tumor imaging classification, surgical approach and irrelevant;3.Craniopharyngioma patients incidence of postoperative hyponatremia disorders:①preoperative presence of diabetes insipidus patients>②chunk of patients without diabetes insipidus-like calcification preoperative> little or no calcification calcification③not expressly reserved by the pituitary stalk> expressly reserved by the pituitary stalk④subtotal subtotal by> most resection⑤tumor diameter greater than4cm are more likely to occur in the postoperative hyponatremia disorder;..⑥the disorder of surgery and postoperative serum potassium and sodium are closely related.4. Sodium disorder types and related factors:according to the statistical analysis, the type of sodium disorders associated with age, gender, tumor size, tumor imaging classification, tumor calcification, surgical approach, intraoperative pituitary stalk reserved circumstances, the extent of tumor resection, preoperative diabetes insipidus cases, preoperative endocrine disorder types were not correlated.5.For craniopharyngioma patients, we should actively improve the preoperative electrolytes and hormones checked, do a better preoperative evaluation, a detailed study of patients with preoperative imaging data, choose the appropriate surgical approach, fine surgical operation, reasonable handling with calcification cases, try to avoid damage to the hypothalamus and pituitary stalk, reduce the incidence of postoperative complications, control the postoperative hyponatremia disorders and diabetes insipidus positively, specification line hormone replacement therapy timely, improve patient prognosis.