Clinical analysis of the related high risk factors of hyponatremia after transsphenoidal approach for pituitary adenomectomy andclinical nursing

Abstract

Objective To explore the related high risk factors of hyponatremia after transsphenoidal approach for pituitary adenomectomy and to direct postoperative nursing. Methods The clinical data of seventy-seven patients suffering from pituitary adenomas with the way of treatment by transsphenoidal pituitary adenomectomy from June 2014 to May 2015 were summarized retrospectively. According to the value of postoperative serum natremia, the data were divided into hyponatremia group and non-hyponatremia group. The different data between the 2 groups were compared and the high risk factors related to hyponatremia were analyzed. Results Univariate analysis showed that gender(P= 0.254)and high blood pressure(P=0.742)were unrelated to postoperative hyponatremia and there was significant difference between two groups in age(P=0.038), max-diameter of tumors(P=0.004), preoperative pituitary dysfunction(P=0.013), visual deficit(P=0.000), operative procedure duration(P= 0.008)and diabetes mellitus rate(P=0.023). While Logistic regression analysis showed that preoperative visual deficit(OR=0.152, P=0.004, 95%CI 0.043-0.542)and preoperative pituitary dysfunction(OR=0.069, P=0.046, 95% CI 0.005-0.950)were independent factors for postoperative hyponatremia. Conclusions Hyponatremia is a common complication after transsphenoidal pituitary adenomectomy. The optimal treatment can benefit the early recovery and more careful nursing should be focused on these patients who are in high risk of postoperative hyponatremia. Key words: Pituitary adenomas; Hyponatremia; Nursing care; Post-operation