中文摘要：

目的总结鞍区占位病变术后伴高钠血症的临床特征及预后。方法回顾性分析我院2004年1月-2014年10月因鞍区占位病变住院患者3 580例,当血钠≥150 mmol/L时考虑高钠血症,若同期血钠〈130 mmol/L考虑高低钠交替血症。分析高钠患者临床特点及预后。结果鞍区占位病变术后高钠血症发生率为5.39%（193例）,原发病病因以颅咽管瘤（n=116,60.1%）、垂体瘤（n=31,16.1%）、生殖细胞瘤（n=11,5.7%）为主。与鞍区病变血钠正常患者（n=200）相比,高钠血症患者死亡率明显升高（4.7%vs 1.1%,P〈0.05）,预后较差;与轻度高钠血症（n=56）相比,重度高钠血症（n=41,血钠≥160 mmol/L）病变侵犯三脑室比例（94.6%）较高（P=0.006）、高钠持续时间较长（9.0 d vs 2.5 d,P=0.000）、出院时血钠恢复比例较低（46.3%vs69.6%,P=0.021）;高低钠交替血症中,与血钠波动较小组（波动〈25 mmol/L）相比,血钠波动较大组（波动≥25 mmol/L）术后住院时间长（P=0.037）、意识障碍发生率高（P=0.006）;多因素分析提示,血钠水平高、病变直径大、血钠波动大和高钠持续时间长是预后不良的危险因素。结论术后发生高钠血症的鞍区占位主要有颅咽管瘤、垂体瘤和生殖细胞瘤等;鞍区病变侵犯三脑室者高钠程度更严重;血钠水平高、病变直径大、高钠持续时间长、血钠波动大者预后不良。

英文摘要：

Objective To analyze clinical features and prognosis of postoperative hypernatremia in patients with space-occupying lesions in sellar region. Methods Clinical data about 3 580 patients with sellar region lesions in department of neurosurgery in our hospital from January 2004 to October 2014 were retrospectively analyzed. Hypernatremia was defined as serum sodium greater than or equal to 150 mmol/L. Multivariable logistic regression analysis was used to analyze the contributing factors to the prognosis（death, disturbance of consciousness, and sober）. Results The prevalence of hypernatremia in these patients was 5.39%（n=193） and it occurred mainly in craniopharyngioma（n=116, 60.1%）, pituitary adenoma（n=31, 16.1%）, and germ cell tumors（n=11, 5.7%）. Compared with eunatremia patients（n=200）, the mortality in hypernatremia was significantly higher with poor prognosis（4.7% vs 1.1%, P〈0.05）. Compared with the mild hypernatremia group（n=56, Na160 mmol/L）, patients with severe hypernatremia（n=41, Na≥160 mmol/L） had a higher proportion of lesion in the third ventricle（94.6%, P=0.006）, longer duration of hypernatremia（9.0 d vs 2.5 d, P=0.000） and lower sodium recovery rate at discharge（46.3% vs 69.6%, P=0.021）. Compared with narrower sodium fluctuation group（fluctuation25 mmol/L）, patients in wider sodium fluctuation group（fluctuation≥25 mmol/L）had longer hospital stay（P=0.037） and higher incidence of conscious disturbance（P=0.006）. Multivariable logistic regression analysis showed that high level of hypernatremia, large tumor size, long time of hypernatremia and wide sodium fluctuation were risk factors of poor prognosis. Conclusion Postoperative hypernatremia in patients with space-occupying lesions of the sellar region mainly occurs in craniopharyngioma, pituitary adenoma and germ cell tumors. Patients with lesion in the third ventricle have higher level of hypernatremia. High level of hypernatremia, large tumor size, long course of hypernatremia and w