Recent Research Of Water And Sodium Disorders In Postoperative Sellar Region Tumors

The tumors in the sellar region include pituitary adenoma,craniopharyngioma,Rathke's cyst,meningioma,and other brain tumors or infiltrative,infectious,vascular diseases.Although most pituitary adenomas are non-secretory,the most common secretory function is prolactinoma.Prolactin tumor is commonly by drug treatment,but there are other secretion of pituitary adenomas and some non-functional sellar region and next to the sellar region tumors cause tumor related symptoms often requires surgery,clinical commonly used surgical method is currently endoscopic resection.This type of operation is usually acceptable and effective.But,in a complex anatomical structures below the thalamus,pituitary stalk,neurohypophysis and limited space with abundant nerves and blood vessels in the implementation of nasal endoscopic surgery,there must be a series of the risk of postoperative complications.If the hypothalamus,pituitary,or damage to the blood vessels in the hypothalamus during the operation,the disorders of sodium electrolyte metabolism and plasma osmotic pressure regulation in postoperative sellar region tumors can be induced.Therefore,water sodium electrolyte metabolism disorder in postoperative sellar region tumors is an inevitable postoperative complication of sellar region tumors,including hypernatremia,hyponatremia,and central diabetes insipidus.Hypernatremia can be divided into high capacity,normal capacity and low blood volume.Hyponatremia based on plasma osmotic pressure and hyposmolality,normal osmotic pressure and hyperosmosis,according to the severity of also can be divided into light,medium and severe hyponatremia,and there are two common causes about it are cerebral saltwasting syndrome(CSWS)and syndrome of inappropriate secretion of antidiuretic hormone(SIADH).The central diabetes insipidus can also be divided into the first phase of temporary central diabetes insipidus,the second phase of the SIADH and the third phase of the permanent central diabetes insipidus.Hypernatremia can do harm to central nervous system.For example,early for irritability,fatigue,and later for gradual changes in the mind,muscle tension,even coma.Hyponatremia can lead to increased intracellular capacity,which can lead to cerebral edema,making the prognosis of the neurologist worse.Abnormal osmotic pressure can be life-threatening if the sodium metabolism disorder is not detected and treated in a timely and early manner.In addition,the etiology,pathogenesis,diagnosis basis,clinical classification and treatment principle of water and sodium electrolyte disordered after postoperative sellar region tumors were not elaborated in the related study.This paper will review the literature and divided metabolic disorders into five types:.(1)Central diabetes insipidus and hyponatremia(2)Central diabetes insipidus and hypernatremia(3)Central diabetes insipidus(4)hyponatremia(5)hypernatremia.By far,few articles have classfied the types of water and sodium metabolic disorder after postoperative sellar region tumors,so this paper can provide new ideas about it.