目的 探討鞍區(qū)腫瘤術后抗利尿激素分泌異常綜合征（SIADH）及腦性鹽耗綜合征（CSWS）的鑒別診斷及治療方法。方法 回顧性分析86例首次接受鞍區(qū)腫瘤術后低鈉血癥患者的臨床表現(xiàn)和實驗室檢查，總結有效的診斷及治療方法。將48例垂體腺瘤患者分為A組，28例顱咽管瘤和10例腦膜瘤患者分為B組；CSWS低鈉者補鈉、迅速擴容、補充高滲鹽水，SIADH低鈉者限水補鹽利尿治療。結果 診斷為SIADH的39例，CSWS的47例。1例于術后8 d死亡；1例出院后1個月發(fā)生低鈉血癥死亡；2例患者因水中毒出現(xiàn)抽搐、昏迷，對癥治療1個月后出院；余82例治療后恢復良好。結論 當鞍區(qū)腫瘤術后的患者合并低鈉血癥時應先排除醫(yī)源性因素，細胞外容量是區(qū)別SIADH與CSWS的可靠指標，體質量及中心靜脈壓檢測簡單有效。

Objective To explore the diagnostic, and therapeutic methods of postoperative symdrome inappropriate secretion of antidiuretic hormone (SIADH) and cerebral salt-wasting syndrome (CSWS) of patients with sellar region tumors. Methods Clinical manifestation and laboratory examination of 86 postoperative hyponatremia patients with sellar region tumors were analyzed retrospectively, and effective diagnosis and treatment were summarized. Forty eight patients with pituitary adenoma were divided into group A, 28 patients with craniopharyngioma, and 10 patients with meningioma were divided into group B; CSWS with hyponatremia should be supplied with sodium, rapidly expanded, and added saline; SIADH should be done diuretic treatment by water restrictions and salt replacement . Results Among 86 case 39 cases were diagnosed with SIADH, and the rest 47 cases were diagnosed with CSWS. One patient died at the day 8 after surgery; one died of hyponatremia that happened after discharging one month later; two patients discharged after one month of treatment, who occurred convulsions and coma as a result of water intoxication. The rest 82 cases recovered well after symtomatic treatments. Conclusion For postoperative hyponatremia patients with sellar region tumors, latrogenic factors of cousing hyponatremia is firstly excluded; extracellular volume is a reliable indicator to make a distinction between SIADH and CSWS, detection of weight and central venous pressure (CVP) is easy and effective.