Clinical Analysis Of Diabetes Insipidus After Single-nostril Transsphenoidal Surgery For Pituitary Adenoma

【Objective】 To investigate the influencing factors and treatment of diabetesinsipidus (DI) after single-nostril transsphenoidal surgery for pituitary adenoma.【Methods】 The clinical records of patients who underwent single-nostriltranssphenoidal resection of pituitary adenoma in our unit from Dec.2008to Dec.2012were analyzed retrospectively. Predictive influencing factors of postoperative DIincluding gender, age, disease duration, tumor size, growing direction, extent ofresection and endocrine function type were investigated. The data were dealt witht-test or χ2test to evaluate the influencing factors of postoperative DI.【Results】 This study enrolled275microscopic transsphenoidal surgeries whosedata of the first24hours after operation were not included in the statistics. And out ofthe275cases, there were96cases of DI（34.9%）, involving93cases of transient DI,2cases of triphasic DI and1case of permanent DI. Statistic analysis showed that theoccurrence of postoperative DI was associated with tumor size, growing direction andextent of resection (P<0.05), but was not associated with gender, age, disease durationand endocrine function type (P>0.05). The incidence rate of postoperative DI inmicroadenoma group and giant adenoma group were both significantly higher thanthat in macroadenoma group, and the differences were statistically significant(P<0.0167). Pituitary adenomas with suprasellar growth had close relation to DI(p=0.000). Pairwise comparison of tumor size showed only differences between totalremoval and most removal were statistically significant (P <0.0167).【Conclusion】 Mastery of relevant occurring factors, meticulous surgical technique,careful preservation of residual functioning pituitary tissue, early diagnosis andproperly treatment are crucial to the prevention and management of DI.