| Objective: This study aimed to analyze the clinical characteristics of patients undergoing transsphenoidal pituitary tumor resection to explore the relationship between the pathological characteristics of patients and the occurrence of hypokalemia,and further reveal the risk factors of occurrence of hypokalemia,and providing scientific methods for the personalized postoperative hypokalemia prevention and treatment.Methods: This study was retrospectively collected patients datas from January 2009 to December 2012 in the First Hospital of Jilin University and the patients were diagnosed with pituitary adenomas,a total of 257 cases of pituitary tumor patients were included in this study.All of the included subjects underwent transsphenoidal pituitary tumor resection and all patients tumor resection were performed by the same surgeon.Student's t or ANOVA test were used to analyze the measurement and the normal distribution of datas.Chi-square or Fisher' exact test were used to compare the data distribution characteristics of count datas.Unconditional logistic regression was used to analyze the odds ratio(OR)and 95% confidence intervals(CIs),Multivariate unconditional logistic regression was used to analyze the independent risk factors of hypokalemia inpituitary adenomas patients.In addition,repeated measures ANOVA was used to analyze change in serum potassium levels at different time points.All statistics were evaluated using SPSS 18.0 software(SPSS Inc.,USA)and P <0.05 was considered statistically significant.Results:(1)In this study,257 pituitary adenomas patients with pituitary tumor were enrolled and 22 patients with postoperative hypokalemia occurred.The mean age of the patients was 45.9±13.0 years.There were 115 males,mean age 47.0 years(17-81 years),and 142 female,the average age of 45.1 years(14-68 years).We included 257 subjects in this study,99(38.5%)were nonfunctioning pituitary adenomas,70(27.2%)were PRL pituitary adenomas,41(16.0%)were GH pituitary adenomas,20(7.8%)were ACTH pituitary adenomas,10(3.9%)were FSH pituitary adenomas and 5(1.9%)were TSH pituitary adenomas.(2)In univariate unconditional logistic regression analysis,the relationship between the hypokalemia and clinical pathological features of pituitary adenomas were analyzed.The origin of pituitary tumor patients(rural vs.urban),length of hospital stay(<12 days vs.?12 days),whether patients with hypertension and pituitary adenomas are ACTH pituitary adenomas are the impact factors for pituitary adenomas patients with hypokalemia.The results showed that the number of days in hospital was ?12 days was the postoperative hypokalemia risk factors in pituitary adenomas(?12 days vs.<12 days: OR=2.80,95% CI: 1.15-6.83,P=0.024)and the risk of hypokalemia was 0.30(OR=0.30,95% CI: 0.11-0.85,P=0.023)in city patients,and Compared with non-hypertensive patients with pituitary adenomas,the hypertensive patients were more likely to be hypokalemia(OR=5.03,95% CI: 2.04-12.41,P<0.001).In addition,ACTH-pituitary adenomas are more common in patients with hypokalemia than nonACTH-pituitary adenomas(non-ACTH-pituitary adenomas vs.ACTH-pituitary adenomas: OR=18.75,95%CI: 6.55-53.66,P<0.001).(3)To explore the independent for hypokalemia,multivariate logistic regression analysis was used to investigate the independent factors of postoperative hypokalemia in pituitary adenomas patients.In the model of multivariate logistic regression,the origin of patients,the length of hospital stay and pituitary adenomas with hypertension or not were included.The results showed that ACTH-pituitary adenomas(OR=6.54,95% CI: 1.76-24.33,P=0.005)was risk factor for postoperative hypokalemia.(4)In order to further verify the risk factors of hypokalemia,we detailed analyzed the clinicopathological types of 22 patients with postoperative hyperkalemia,there are including 10 ACTH pituitary adenoma(50%),and 5 PRL pituitary adenoma,3 GH pituitary adenoma,2 non-functional pituitary adenoma,1 FSH pituitary adenoma,1 TSH pituitary adenoma and 1 mixed type of pituitary adenoma,we divided those into ACTH group and non-ACTH group(control group).The risk factors of hypokalemia after pituitary tumor surgery were analyzed by repeated measures ANOVA.The results showed that ACTH pituitary tumor patients prone to postoperative hypokalemia(P=0.005).Conclusion: Pituitary adenoma is classified as ACTH pituitary adenoma is an independent risk factor for postoperative hypokalemia.Clinical work should focus on monitoring the changes of serum potassium with ACTH pituitary adenoma patients after surgery.If there were hypokalemia occuring,immediately supplied serum K+ in vitro,reduce the postoperative complications of pituitary adenomas patients in greatest degree and improve patients quality of life. |
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