摘要
目的分析非侵袭型垂体泌乳素腺瘤经蝶手术疗效，为临床治疗的选择提供参考。方法回顾性分析我科近10年来经蝶手术治疗的234例患者手术疗效，并分析影响手术疗效的因素。结果术后出现一过性水、电解质紊乱者127例（54．3％）。治愈188例（80．3％），缓解12例（5．1％），进步20例（8．5％），无效14例（6．0％）。无手术死亡。患者性别、肿瘤大小和术前泌乳素水平对经蝶术后疗效有极显著影响，而术前病程、术前服用溴隐停与否、肿瘤质地、肿瘤是否卒中、术中鞍膈下降程度等对经蝶手术疗效没有明显影响。经蝶手术的总费用为（12912．0±2361．2）元。结论经蝶显微手术治疗可以作为非侵袭型垂体泌乳素腺瘤尤其是微腺瘤和大腺瘤的一级治疗方法。
Objective To analyze the transspbenoidal microsurgical results of non-invasive prolactinomas, in order to provide reference for their treatment choice. Methods To review the transsphenoidal microsurgieal results of 234 non-invasive prolaetinomas treated in our department in recent 10 years, and to analyze the prognostic factors. There were 18 males and 216 females, aged between 13 and 58 years, averaged （31.1 ± 8. 5） years. The course ranged from half a month to 20 years, averaged （47.3 ± 44. 9） months. The preoperative serum PRL level ranged between 41 and 8406 ng/ml, averaged （400. 5 ± 888.0） ng/ml, with a median of 164. 1ng/ml. The primary symptoms were amenorrhea, galaetorrhea and/ or infertility in 211 eases. The tumor size was small （ 〈 1 cm） in 100, large （ ≥1 cm） in 116 and giant （ ≥3 cm） in 18 eases. All the patients received transsphenoidal mierosurgery and were followed-up for 12 to 132 months, averaged （43.8 ±35. 0） months. Results There was no mortality. One hundred and twenty- seven （ 54. 3% ） cases had transient postoperative imbalance of water and electrolytes. One hundred and eighty-eight eases （80. 3% ） were cured, 12 （5. 1% ） experienced clinical remission, 20 （8. 5% ） were improved, and 14 （6.0%） were ineffective. The male patient, the giant prolaetinomas and those with higher preoperative serum PRL level had a relative poor postoperative prognosis. While the other factors had no influence on prognosis, including the course, preoperative bromocriptine intake, tumor texture, tumor apoplexy and intraoperative descending extent of the diaphragm of sella. The overall operative expense for transsphenoidal mierosurgery ranged from 8323. 8 to 22 898. 5 yuan, averaged （ 12 912.0 ±2361.2） yuan. Condusions Transsphenoidal microsurgery may be chosen as the primary therapy for non-invasive prolactinomas, with the purposes of therapeutical efficacy, facilitating the patients, re-establishing the patients＇ self-confidence and reducing the overall expense.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2008年第4期293-295,共3页
Chinese Journal of Surgery
关键词
催乳素瘤
垂体
非侵袭型
经蝶显微外科手术
Prolactinoma
Hypephysis
Non-invasive
Transsphenoidal microsurgery
