Analysis Of Sodium Disorders After Resection Of Affection In And Around Saddle Area

Objectives: Sodium disorders is a frequent complication after resection of affection in and around saddle area. I mainly discuss the types, etiological factor, pathogenesis, treatment and outcome of sodium disorders in this article.Methods: To retrospectively study 105 patients with affection in and around saddle area in our department of neurosurgery between October 2004 and November 2007. Of 105 patients, 7 patients was under 20 years old, 55 patients was between 21-40 years old, 24 patients was between 41-60 years old, 19 patients was over 60 years old, 53 patients suffered from pituitary adenoma, 20 patients suffered from craniopharyngioma, 6 patients suffered from gliomas in hypothalamus and the third cerebral ventricle, 9 patients suffered from meningeoma, 17 patients suffered from aneurysms subarachnoid hemorrhage, 37 patients had coincided with diabetes. All patients were confirmed by CT, MRI, DSA or pathology, and the function of thyroid gland,heart,liver,kidney was normal. And all patients was checked out electrolyte and kidney function on the day of hospital admission and at 1 day postoperation. If sodium was abnormal, it was rechecked 1-2 times in one day. If sodium was normal, it was rechecked 1 time in 3-5 days. Meanwhile we monitored heart rate, blood pressure and urine volume in 24 hours of all patients. If sodium was abnormal, we also continuously monitored consciousness. We classified sodium disorders as hypernatremia and hyponatremia on the basis of clinical manifestation and result of laboratory examination. To compare the morbility of hypernatremia and hyponatremia caused by the identical factor. And then we made a statistic analysis of the morbility with chi square test(χ2). That the value of P is less than 0.05 make sense in statitics(P<0.05). Results: 46(43.81%, 46/105) patients suffered from sodium disorders. 24 (22.86%, 24/105) patients suffered from hypernatremia. 22(20.95%, 22/105) patients suffered from hyponatremia. Of 53 cases with pituitary adenoma, 29 grew to suprasellar or encroaching hypothalamus, 24 were in sellar. Among 29 cases,10 (34.48%,10/29) showed hypernatremia, 1(3.45%, 1/29) showed hyponatremia(P<0.05). Among 24 cases ,1(4.17%, 1/24) showed hypernatremia, 9(37.50%, 9/24) showed hyponatremia(P<0.05). Among 20 patients with craniopharyngioma, 8(40%, 8/20) showed hypernatremia, 3(15%, 3/20) showed hyponatremia(P<0.05). Among 6 patients with gliomas in hypothalamus and the third cerebral ventricle, 2(33.33%, 2/6) showed hypernatremia, none showed hyponatremia(none statistic analysis). Among 9 patients with meningeoma, 2(22.22%, 2/9) showed hypernatremia, 3(33.33%, 3/9) showed hyponatremia(P>0.05). Among 17 patients with aneurysms subarachnoid hemorrhage, 1(5.88%, 1/17) showed hypernatremia, 6(35.29%, 6/17) showed hyponatremia(P<0.05). Among 19 gerontic patients, 1(5.26%, 1/19) showed hypernatremia, 8(42.11%, 8/19) showed hyponatremia(P<0.05). Among 37 patients coinciding with diabetes, 12(32.43%, 12/37) showed hypernatremia, 2(5.41%, 2/37) ca showed hyponatremia(P<0.05).Conclusions: Patients with affection in saddle and around area are subject to sodium disorders. The type of sodium disorders of patients suffering from tumors growing to suprasellar or encroaching hypothalamus and of patients coinciding with diabetes is more hypernatremia. The type of sodium disorders of patients suffering from tumors in sellar and aneurysms subarachnoid hemorrhage is more hyponatremia. We should diagnose sodium disorders in time and take resolute and efficient treatment. The outcome of most patients is healing well after efficient treatment.