Analysis of Hypothalamic Reactions Shortly after the Resection of the Third Ventricle Tumor via Transcallosal-interforniceal Approach_West China Medical Journal

Authors：

LI Hong ^1,2 , LIU Yanhui ¹ , LIU Jiagang ² , WANG Xiang ¹ , MA Lu ¹ ,  MAO Qing ¹

1. Department of Neurosurgical, the First People’s Hospital of Yibin, Yibin, Sichuan 644000, P. R. China; 2. Department of Neurosurgical, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

MAO Qing, Email: lh19840408@163.com

Keywords：

經穹窿-胼胝體; 第三腦室; 腫瘤; 下丘腦反應

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目的　探討經胼胝體-穹窿間入路切除第三腦室腫瘤術后，近期下丘腦反應的發生情況及相關因素，為防治第三腦室腫瘤術后下丘腦反應提供參考。方法　回顧分析2003年1月－2008年12月經胼胝體-穹窿間入路切除的78例第三腦室腫瘤患者手術后近期（1個月內）下丘腦反應的發生情況，并將其按照腫瘤部位、病理性質、大小、血供、手術切除程度進行分類統計，用SPSS 13.0軟件logistic 回歸分析影響這些并發癥的因素。結果　78例術后下丘腦反應37例，發生率47.4%；死亡5例，下丘腦反應病死率為13.5%（5/37）。其中電解質糖代謝紊亂33例（42.3%），尿崩癥27例（34.6%），激素水平低下16例（20.5%），高熱6例（7.7%）。好轉痊愈率：激素水平低下43.7%，其余均＞70%。第三腦室前部顱咽管瘤術后最容易發生下丘腦反應（P＜0.05）。結論　經胼胝體-穹窿間入路切除第三腦室腫瘤術后近期存在程度不同的下丘腦反應，其發生與腫瘤部位、病理性質有密切關系。經積極治療，大部分下丘腦反應能在術后1個月內好轉甚至痊愈。

Citation： LI Hong,LIU Yanhui,LIU Jiagang,WANG Xiang,MA Lu,MAO Qing. Analysis of Hypothalamic Reactions Shortly after the Resection of the Third Ventricle Tumor via Transcallosal-interforniceal Approach. West China Medical Journal, 2012, 27(3): 343-346. doi: Copy

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1. 　丁育基. 顱腦重癥與手術并發癥的臨床處理[M]. 北京出版社, 2002: 494-499.
2. 　Apuzzo ML, Chikovani OK, Gott PS, et al. Transcallosal approaches for lesions affecting the third ventricle: surgical considerations and consequences[J]. Neurosurg, 1982, 10(5): 547-554.
3. 　石祥恩, 王忠誠, 張懋植. 顱咽管瘤全切術中的下丘腦功能保護[J]. 中華神經外科雜志, 1999, 15(6): 342.
4. 　Cutis J, Daneman D, Hoffman H J, et al. The endocrine outcome after surgical removal of craniopharyngiomas[J]. Pediatric Neurosurg, 1994, 21 (Suppl 1): 24-27.
5. 　Zhang YQ, Wang ZC, Ma ZY, et al. Resection of children craniopharyngiomas and preventions of functional impairments of hypothalamus[J]. Chin J Neurosurg, 2001, 17(6): 340-343.
6. 　Shi XE, Wang ZC, HuangWY. The treatment of water and sodium disorders after total resection of craniopharyngioma[J]. Chin J Neurosurg, 2000, 16(4): 210-212.
7. 　楊樹源, 只達石, 張建寧, 等. 神經外科學[M]. 人民衛生出版社, 2008, 1: 80-93.
8. 　張玉琪, 王忠誠, 馬振宇. 兒童顱咽管瘤189例臨床分析[J].中華醫學雜志, 2000, 86(4): 280-282.
9. 　SHI XE, WU B, FAN T, et al. Craniopharyngiomas: surgical experience of 309 cases in China[J]. Clini Neurol Neurosurg, 2008, 110(2): 151-159.
10. 　鄭細涼, 張玉琪.顱咽管瘤術后激素替代治療[J].中華神經外科雜志, 2006, 22(2): 127-129.
11. 　Ronen S, Shlomi C, Herzel G, et al. Association of prolonged fever and hypernatremia: rare presentation of hypothalamic/third ventricle tumor in a toddler[J]. J Pediatric H/O, 2002, 3(24): 227-228.

West China Medical Journal

Analysis of Hypothalamic Reactions Shortly after the Resection of the Third Ventricle Tumor via Transcallosal-interforniceal Approach

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