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目的 分析探讨垂体瘤术后高渗性非酮症糖尿病昏迷 (HNDC)的诱发因素。方法 总结了 13例经术后病理证实为垂体瘤 ,在发生HNDC后的临床表现和检验结果特点。结果 全部病例术后出现高血糖 ,平均血糖 6 4mmol/L ,全部病例在 2 4～ 4 8小时内出现高血钠 ,血钠水平 15 0～ 185mmol/L。结论 诱发垂体瘤术后HNDC的因素有手术创伤、高龄、出血、限水摄入和脱水利尿剂应用 ,且它们能导致有效循环血容量下降和电解质平衡紊乱 ,从而诱发HNDC。高钠是导致昏迷的主要原因。
Objective To analyze the predisposing factors of hypertonic non-ketotic diabetic coma (HNDC) after pituitary tumor surgery. Methods The clinical manifestations and test results of 13 cases of pituitary tumors confirmed by postoperative pathology after HNDC were summarized. Results All patients had postoperative hyperglycemia with an average blood glucose of 6 4 mmol/L. All cases had hypernatremia within 24 to 48 hours. Serum sodium levels were 15 0 to 185 mmol/L. Conclusion The factors inducing HNDC after pituitary adenoma surgery include surgical trauma, advanced age, hemorrhage, limited water intake and dehydration diuretics. They can lead to decreased circulating blood volume and disturbance of electrolyte balance, which induces HNDC. High sodium is the main cause of coma.