【摘要】 目的研究颅咽管瘤手术前及手术后内分泌激素的变化,为颅咽管瘤手术后激素替代治疗提供依据。方法我科2001年6月～2002年12月共手术切除颅咽管瘤40例,其中15例为再次手术。在手术前和手术后1周分别采静脉血,测定T3、T4、TSH、ADH、ACTH水平,记录手术前后24h尿量,测尿比重、血浆渗透压、尿渗透压;将所得数据进行统计学分析。结果手术后甲状腺功能低下和尿崩的出现率(分别为95%和95%)显著高于术前(分别为70%和57.5%);术后血浆ACTH水平(15.60±1.91)pg/ml,显著低于术前的(23.97±2.69)pg/ml。手术前、手术后血浆ADH水平差异无显著性,分别为(2.49±0.30)pg/ml和(2.80±0.29)pg/ml。结论颅咽管瘤手术后内分泌功能紊乱是常见的合并症;颅咽管瘤手术后除需常规补充肾上腺皮质激素外,还应补充甲状腺素。更多还原

【Abstract】 Objective To study the endocrine changes in patients with craniopharyngiomas before and after operation, get the basis for hormone replacement therapy after the resection of craniopharyngiomas. Methods 40 craniopharyngiomas were resected from June 2001 to December 2002. 15 of them were undergone secondary surgery. The vein blood samples were taken before operation and 1 week after operation respectively, and T3, T4, TSH, ADH, ACTH were assayed. The volume of 24 hours urine was recorded,and the specific gravity of urine osmotic pressure of plasma and urine were recorded too. The data was statistically analyzed. Results There is significantly higher incidence of hypothyroidism and diabetes insipidus after surgery (95% and 95% respectively) than that before surgery (70% and 57.5% respectively). Postoperative plasma ACTH concentration, mean (15.60 ± 1.91) pg/ml, is significantly lower than preoperative which mean (23.97 ± 2.69) pg/ml. There is no significant difference between plasma ADH before and after surgery, which mean (2.49 ± 0.30) pg/ml and (2.80 ± 0.29) pg/ml respectively. Conclusion The endocrine abnormalities after the resection of craniopharyngiomas appear to be the common complication of the surgery. Thyroxin should be administered routinely as well as the glucocorticoid after craniopharyngioma operation.更多还原