经鼻蝶入路垂体瘤切除术后尿崩症的护理体会-《西部中医药》

文章信息/Info

Title:: Nursing Experience of Patients with Diabetes Insipidus after the Resection of Pituitary Tumor through Nose-Sphenoid Sinus

Author(s):: YAN Hongyan; The Second A ffiliated Hospital of Nantong University, Nantong 226001, China

Keywords:: pituitary tumor; diabetes insipidus; antidiuretic hormone; surgery

摘要:: 目的：观察综合护理对鼻蝶入路垂体瘤切除术后尿崩症恢复的影响。方法：将 90 例脑垂体腺瘤患者随机分为 3 组，经鼻前庭 - 鼻中隔 - 蝶窦切除术的 A 组、经口唇下 - 鼻中隔 - 蝶窦切除术的 B 组、内镜辅助下经鼻 - 蝶窦手术的 C 组各 30 例，3 组术后均予体液、心理、环境、尿道的综合护理，同时观察术后尿崩症发生的例数、血管升压素的水平以及每小时尿量的变化情况。结果：C 组共发生尿崩症 9 例，明显少于 A、B 两组；C 组血管升压素明显高于 A、B 2 组；尿崩症患者术后 3 天每小时尿量明显低于术后 1 天，血管升压素水平明显高于术后 1 天。结论：内镜辅助经鼻 - 蝶窦手术能有效减少术后尿崩症的发生，且综合护理措施能有效促进尿崩症患者的恢复。

Abstract:: Objective: To observe the effects of comprehensive care for the recovery of patients with diabetes insipidus after the resection of pituitary tumor through nose-sphenoid sinus. Method: All 90 patients were randomized into three groups: group A of resection through nasal vestibule-nasal septum-sphenoid sinus, group B of resection through lips- nasal septum-sphenoid sinus and group C of resection through nose- sphenoid sinus and endoscope. The groups received comprehensive nursing of body fluid, psychology, environment and urinary tract, meanwhile the number of cases with diabetes insipidus, the level of antidiuretic hormone and changes of urinary volume each hour were observed. Result: Nine cases in group C occurred diabetes insipidus, less than group A and B obviously; the levels of antidiuretic hormone were higher than group A and B significantly; the urinary volume each hour in three days after surgery was less than that in one day, the level of antidiuretic hormone was higher than that in one day after surgery. Conclusion: Endoscope combined with the surgery through nose-sphenoid sinus could effectively reduce the onset of diabetes insipidus after surgery and comprehensive nursing measures could promote the recovery of diabetes insipidus.