【摘要】 目的 分析颅咽管瘤术前泌乳素(PRL)、促甲状腺激素(TSH)和促肾上腺皮质激素(ACTH)的变化,探讨术前激素变化与术后尿崩症的关系,为术后并发症的防治及预后的评估提供参考依据。 方法 对2003年3月-2007年6月收治的96例颅咽管瘤患者进行回顾性分析。对患者术前的激素(PRL、TSH及ACTH)检测结果与术后尿崩症的关系进行分析;按照术前有异常的激素种类将患者分为Ⅰ组(术前无激素的改变)、Ⅱ组(术前有任意1种激素发生改变)、Ⅲ组(术前有任意2种激素发生改变)及Ⅳ组(术前3种激素都发生改变)组。分析不同组别与术后尿崩症的关系。 结果 术前PRL、TSH及ACTH有改变的患者术后尿崩症发生率高于术前上述激素无改变的患者,PRL、TSH及ACTH发生改变的种类越多,术后尿崩症发生率越高。 结论 术前PRL、TSH及ACTH的改变和改变的种类多少可以作为判定术后并发症和评估预后的参考指标之一。
【Abstract】 Objective To observe the changes of prolactin (PRL), thyroid stimulating hormone (TSH), and adrenocorticotropic hormone (ACTH) in patients with craniopharyngiomas before surgery; and to analyze the relationship between their changes and incipidus after the surgery to get the basis for postoperative complications and prognosis. Methods Ninety-six patients with craniopharyngiomas from March 2003 to July 2007 were seleted. The relationship between endocrine changes before surgery and diabetes insipidus after surgery was analyzed. The patients were divided into four groups:no endocrine changed in group Ⅰ, one hormone changed in group Ⅱ, two hormones changed in group Ⅲ, and all the three hormones changed in group Ⅳ. The relationship between different groups and diabetes insipidus was analyzed. Results The pre-operative endocrine abnormalities was the sign of hypothalamus injury. There were significantly higher incidences of diabetes insipidus after the surgery in patients with endocrine abnormalities than that in the patients without any endocrine changes. There were significantly different incidence of diabetes insipidus after the surgery in different groups. Conclusion The pre-operative endocrine changes can be the guideline to predict the postoperative diabetes insipidus and to evaluate the prognosis.
Citation:
SONG Bo,MAO Qing. Relationship between the Hormones Changes in Patients with Craniopharyngioma before the Surgery and Diabetes Insipidus after the Surgery. West China Medical Journal, 2010, 25(10): 1833-1835. doi:
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1. |
Thomsett MJ, Conte FA, Kaplan SL, et al. Endocrine and neurologic outcome in childhood craniopharyngioma: review of effect of treatment in 42 patients[J]. J Pediat, 1980, 97(5): 728-735.
|
2. |
Yasargil MG, Curcic M, Kis M, et al. Total removal of craniopharyngiomas, approach and long term results in 144 patients[J]. Jneurosurg, 1990, 73(12): 3-11.
|
3. |
Lyen KR, Grant DB. Endocrine function, morbidity and mortality after surgery foe craniopharyngioma[J]. Arch Dis Child, 1982, 57(11): 837-841.
|
4. |
周慕英, 瞿绍忠, 葛建国. 中枢性尿崩症100例临床研究[J]. 天津医药, 1990, 12(3): 716-719.
|
5. |
Mootha SL, Barkovich AJ, Grumbach MM, et al. Idiopathic hypothalamic diabetes insipidus, pituitary stalk thickening, and the occult intracranial germinoma in children and adolescents[J]. J Clin Endocrinol Metab, 1997, 82(7): 1362-1367.
|
6. |
顾锋, 金自孟, 张殿喜, 等. 中枢性尿崩症408例的病因及临床特点分析[J]. 中华医学杂志, 2001, 81(19): 1166-1171.
|
7. |
李德坤, 王志刚, 曲春城. 颅咽管瘤手术前后内分泌水平的变化及其临床意义[J]. 中华外科杂志, 2006, 44(22): 1571-1572.
|
- 1. Thomsett MJ, Conte FA, Kaplan SL, et al. Endocrine and neurologic outcome in childhood craniopharyngioma: review of effect of treatment in 42 patients[J]. J Pediat, 1980, 97(5): 728-735.
- 2. Yasargil MG, Curcic M, Kis M, et al. Total removal of craniopharyngiomas, approach and long term results in 144 patients[J]. Jneurosurg, 1990, 73(12): 3-11.
- 3. Lyen KR, Grant DB. Endocrine function, morbidity and mortality after surgery foe craniopharyngioma[J]. Arch Dis Child, 1982, 57(11): 837-841.
- 4. 周慕英, 瞿绍忠, 葛建国. 中枢性尿崩症100例临床研究[J]. 天津医药, 1990, 12(3): 716-719.
- 5. Mootha SL, Barkovich AJ, Grumbach MM, et al. Idiopathic hypothalamic diabetes insipidus, pituitary stalk thickening, and the occult intracranial germinoma in children and adolescents[J]. J Clin Endocrinol Metab, 1997, 82(7): 1362-1367.
- 6. 顾锋, 金自孟, 张殿喜, 等. 中枢性尿崩症408例的病因及临床特点分析[J]. 中华医学杂志, 2001, 81(19): 1166-1171.
- 7. 李德坤, 王志刚, 曲春城. 颅咽管瘤手术前后内分泌水平的变化及其临床意义[J]. 中华外科杂志, 2006, 44(22): 1571-1572.
Journal type citation(5)
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2. | 李昕,董明,徐嵩,赵洪林,韦森,宋作庆,刘明辉,任典,任凡,赵青春,刘仁旺,夏春秋,陈钢,陈军. 肺部结节及肺癌患者新型冠状病毒感染后肺部手术时机的初步建议. 中国肺癌杂志. 2023(02): 148-150 . Baidu Scholar | |
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Other types of references(2)
1. | 吴琳. 174例新型冠状病毒肺炎患者的中医证型及临床特征分析[D]. 湖北中医药大学. 2023. Baidu Scholar | |
2. | 刘文婷. 阐释学视角下《广瘟疫论》(节选)汉英翻译实践报告[D]. 湖北中医药大学. 2023. Baidu Scholar | |