The Influencing Factors And Methods Of Prevention And Treatment Of Diabetes Insipidus After Surgery For Pituitary Adenoma

Background Pituitary adenoma is a kind of common neuroendocrine tumors in the Department of Neurosurgery.It mainly originates from the anterior pituitary,but may also originate from the posterior pituitary and craniopharyngioma cells and the residual cells of craniopharyngeal duct[1].Recent epidemiological survey,the incidence rate Pituitary adenoma is 7.5-15/100 thousand people.It is 8%-15% of brain tumors[2].so far,the main treatment for pituitary tumor is surgical resection.the transsphenoidal Surgery and tanscrainal surgery for Pituitary Adenoma is the main surgical methods.In 1889,Horsley performed the first tanscrainal surgery for Pituitary Adenoma..the transsphenoidal Surgery for Pituitary Adenoma is Invention by Schloffe in 1907,but because of the poor lighting conditions,surgical instruments,it were not exposed the tumor well,also,it was difficultly to Control bleeding and caused more complications.the operation has not been widely used.In the 60 s of last century,the surgical microscope was applied to the clinic.Hardy was first used in transsphenoidal surgery for pituitary adenoma in the year of 1967.It has been greatly improved curative effect by the advantages of magnification and illumination.Because of its high resection rate,less surgical trauma,less postoperative response,less complications and faster recovery,transsphenoidal surgery for Pituitary Adenoma is more widely used than the tanscrainal surgery for Pituitary Adenoma.However,some of the tumors that is above sellae diaphragma still need to be resected by the tanscrainal surgery for Pituitary Adenoma.Pituitary tumor postoperative complications include: sella turcica bleeding,nose bleeding,cerebrospinal rhinorrhea and intracranial infection,diabetes insipidus,hypopituitarism,ophthalmoplegia,septum damage.While the diabetes insipidus is one of the most common complications of pituitary adenoma resection.Objective 120 postoperative patients who underwent Pituitary tumor surgery were selected from the The second hospital of dalian medical university from 2009 to2017.The clinical data analysis of the relationship pituitary adenoma postoperative diabetes insipidus with age,gender,tumor size,hormone types,tumor invasion,tumor growth direction(whether through the sellar diaphragm),surgical approach and the extent of tumor resection.Pathogenesis of pituitary adenoma postoperative diabetes insipidus and the diagnosis and treatment of it.Methods All the clinical data is analyzed by SPSS19.0 software the measurement data is analyzed by t test.The comparison of the numeration data is analyzed by X2 test.Fist,we analysis the correlation of single factor with pituitary adenoma postoperative diabetes insipidus.then,When P<0.05,the difference was significant.Then,we analysis the correlation of the factors that the difference was significant with with pituitary adenoma postoperative diabetes insipidus.When P<0.05,the difference was significant.Results there are 37 cases of postoperative diabetes insipidus in the 120 postoperative patients who underwent Pituitary tumor surgery.The incidence rate of diabetes insipidus was 30.8%.the statistical analysis showed that the size of the tumor are independent risk factors of diabetes insipidus after surgery(W=5.742 P=0.017OR=10.894).The incidence rate of diabetes insipidus of Giant pituitary adenoma >that of pituitary macroadenoma >that of pituitary microadenoma The growth direction(whether through the sellar diaphragm)of the tumor are independent risk factors of diabetes insipidus after surgery(W=4.351 P=0.026 OR=0.035).the tumor through the sellar diaphragm are more susceptible to diabetes insipidus.Than that not through the sellar diaphragm.Conclusion 1.the occurrence of postoperative diabetes insipidus was associated with tumor size,growing direction(p<0.05),but was not associated with gender,age,hormone types,surgical approach and the extent of tumor resection(P>0.05).The incidence rate of diabetes insipidus of Giant pituitary adenoma > that of pituitary macroadenoma >that of pituitary microadenoma.the tumor through the sellar diaphragm are more susceptible to diabetes insipidus.Than that not through the sellar diaphragm.2.paying attention to the protection of hypothalamus,pituitary stalk,pituitary tissue and blood supply,Correct diagnosis and treatment in time,is the key to the prevention and treatment of postoperative diabetes insipidus...