Relationship between the Hormones Changes in Patients with Craniopharyngioma before the Surgery and Diabetes Insipidus after the Surgery_West China Medical Journal

Authors：

SONG Bo ^1,2 ,  MAO Qing ¹

1. Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China; 2. Department of General, Sichuan Cancer Hospital, Chengdu, Sichuan 610041, P.R. China;

Corresponding?author：

MAO Qing, Email: swb_8210@yahoo.cn

Keywords：

顱咽管瘤; 激素; 尿崩癥; 術后并發癥

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【摘要】目的 分析顱咽管瘤術前泌乳素（PRL）、促甲狀腺激素（TSH）和促腎上腺皮質激素（ACTH）的變化，探討術前激素變化與術后尿崩癥的關系，為術后并發癥的防治及預后的評估提供參考依據。方法對2003年3月-2007年6月收治的96例顱咽管瘤患者進行回顧性分析。對患者術前的激素（PRL、TSH及ACTH）檢測結果與術后尿崩癥的關系進行分析；按照術前有異常的激素種類將患者分為Ⅰ組（術前無激素的改變）、Ⅱ組（術前有任意1種激素發生改變）、Ⅲ組（術前有任意2種激素發生改變）及Ⅳ組（術前3種激素都發生改變）組。分析不同組別與術后尿崩癥的關系。結果術前PRL、TSH及ACTH有改變的患者術后尿崩癥發生率高于術前上述激素無改變的患者，PRL、TSH及ACTH發生改變的種類越多，術后尿崩癥發生率越高。結論術前PRL、TSH及ACTH的改變和改變的種類多少可以作為判定術后并發癥和評估預后的參考指標之一。
【Abstract】 Objective To observe the changes of prolactin (PRL), thyroid stimulating hormone (TSH), and adrenocorticotropic hormone (ACTH) in patients with craniopharyngiomas before surgery; and to analyze the relationship between their changes and incipidus after the surgery to get the basis for postoperative complications and prognosis. Methods Ninety-six patients with craniopharyngiomas from March 2003 to July 2007 were seleted. The relationship between endocrine changes before surgery and diabetes insipidus after surgery was analyzed. The patients were divided into four groups:no endocrine changed in group Ⅰ, one hormone changed in group Ⅱ, two hormones changed in group Ⅲ, and all the three hormones changed in group Ⅳ. The relationship between different groups and diabetes insipidus was analyzed. Results The pre-operative endocrine abnormalities was the sign of hypothalamus injury. There were significantly higher incidences of diabetes insipidus after the surgery in patients with endocrine abnormalities than that in the patients without any endocrine changes. There were significantly different incidence of diabetes insipidus after the surgery in different groups. Conclusion The pre-operative endocrine changes can be the guideline to predict the postoperative diabetes insipidus and to evaluate the prognosis.

Citation： SONG Bo,MAO Qing. Relationship between the Hormones Changes in Patients with Craniopharyngioma before the Surgery and Diabetes Insipidus after the Surgery. West China Medical Journal, 2010, 25(10): 1833-1835. doi: Copy

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7.	李德坤, 王志剛, 曲春城. 顱咽管瘤手術前后內分泌水平的變化及其臨床意義[J]. 中華外科雜志, 2006, 44(22): 1571-1572.

1. Thomsett MJ, Conte FA, Kaplan SL, et al. Endocrine and neurologic outcome in childhood craniopharyngioma: review of effect of treatment in 42 patients[J]. J Pediat, 1980, 97(5): 728-735.
2. Yasargil MG, Curcic M, Kis M, et al. Total removal of craniopharyngiomas, approach and long term results in 144 patients[J]. Jneurosurg, 1990, 73(12): 3-11.
3. Lyen KR, Grant DB. Endocrine function, morbidity and mortality after surgery foe craniopharyngioma[J]. Arch Dis Child, 1982, 57(11): 837-841.
4. 周慕英, 瞿紹忠, 葛建國. 中樞性尿崩癥100例臨床研究[J]. 天津醫藥, 1990, 12(3): 716-719.
5. Mootha SL, Barkovich AJ, Grumbach MM, et al. Idiopathic hypothalamic diabetes insipidus, pituitary stalk thickening, and the occult intracranial germinoma in children and adolescents[J]. J Clin Endocrinol Metab, 1997, 82(7): 1362-1367.
6. 顧鋒, 金自孟, 張殿喜, 等. 中樞性尿崩癥408例的病因及臨床特點分析[J]. 中華醫學雜志, 2001, 81(19): 1166-1171.
7. 李德坤, 王志剛, 曲春城. 顱咽管瘤手術前后內分泌水平的變化及其臨床意義[J]. 中華外科雜志, 2006, 44(22): 1571-1572.

West China Medical Journal

Relationship between the Hormones Changes in Patients with Craniopharyngioma before the Surgery and Diabetes Insipidus after the Surgery

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