摘要
目的 :探讨经蝶入路手术治疗泌乳素 (PRL)腺瘤、生长激素 (GH)腺瘤和促肾上腺皮质激素 (ACTH)腺瘤的效果及手术前后血清内分泌学变化。方法 :我科 1995年 10月至 2 0 0 2年 9月用显微外科手术治疗垂体腺瘤 2 5 4例 ,其中具有完整血清内分泌学检查结果和 MRI随访资料的功能性垂体腺瘤 14 3例 ,其中 PRL腺瘤 6 1例 ,GH腺瘤 5 0例 ,ACTH腺瘤 32例。平均随访时间为 2 .3年。结果 :GH腺瘤和 ACTH腺瘤的全切率明显高于 PRL腺瘤 (P<0 .0 1) ,GH腺瘤与 ACTH腺瘤相差不显著 (P>0 .0 5 )。肿瘤的全切率与肿瘤的大小相关 (P<0 .0 5 ) ,微腺瘤全切率高于大腺瘤。肿瘤全切率与肿瘤侵袭性明显相关(P<0 .0 5 )。PRL腺瘤的复发率明显高于 GH腺瘤和 ACTH腺瘤 (P<0 .0 5 )。侵袭性垂体腺瘤的复发率高于非侵袭性垂体腺瘤 (P<0 .0 5 )。术后血清内分泌水平均全面降低。结论 :GH腺瘤与 ACTH腺瘤的治疗效果优于 PRL腺瘤。
Objective:To study the effectiveness of transsphenoidal surgery for GH ,ACTH ,and PRL secreting pituitary adenomas.Methods:Among 254 patients with diagnosed pituitary adenomas from Oct.1995 to Sep.2002,143 cases of secreting pituitary adenomas(56.3%) had the full endocrinological testing and MRI follow up information (61 PRL ,50 GH ,32 ACTH ).The median follow up time was 2.3 years.Results:The total removal rate for PRL secreting adenomas (34.4%) was significantly lower than that for GH (68.0%) and ACTH secreting (78.1%) adenomas( P <0.01).Total removal rate was correlated with tumor size and invasiveness:that of microadenomas was higher than macroadenomas( P <0.05) and that of noninvasive adenomas was higher than invasive adenomas( P <0.05).The recurrence rate of PRL secreting adenomas was higher than that of ACTH and GH secreting adenomas ( P <0.05); that of invasive adenomas was higher than noninvasive adenomas( P <0.05).Hormonal level in secreting pituitary adenomas had an overall decrease postoperatively.Conclusion:The therapeutic effects of GH and ACTH secreting pituitary adenomas are better than that of PRL secreting adenomas.The therapeutic effects of secreting pituitary adenomas are related to their endocrinological feature and invasiveness.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
2003年第8期840-842,共3页
Academic Journal of Second Military Medical University
