摘要
目的研究青春期垂体腺瘤的临床特点及显微外科手术治疗的短期(6个月)和长期(2年)疗效。方法回顾性研究1995年6月至2003年6月,经手术和病理证实的青春期垂体腺瘤患者的临床特点,根据肿瘤病理类型或直径大小分组,大腺瘤(直径>10mm)为A组,小腺瘤和微腺瘤(直径≤10mm)为B组。术后随访治疗效果。结果青春期垂体腺瘤48例,其中催乳素(PRL)腺瘤23例,非功能性(NF)腺瘤11例,生长激素(GH)腺瘤9例,促肾上腺皮质激素(ACTH)腺瘤5例。术后6个月A组治愈和控制率为73.0%(27/37),B组为90.9%(10/11);术后2年A组治愈和控制率为64.9%(24/37),B组为81.8%(9/11),2组比较治愈率和控制率均有显著性差异(P<0.01)。PRL腺瘤术后2年治愈率为60.9%(14/23),控制率为21.7%(5/23);GH腺瘤术后2年治愈率为66.7%(6/9);NF腺瘤2年治愈率为54.5%(6/11)。结论对青春期垂体腺瘤进行显微手术治疗是一种安全有效的首选方法,但应严格掌握手术指征。大腺瘤术后放疗和药物辅助治疗可以提高治愈率,但放射治疗应严格掌握适应证,以防止出现延迟性垂体功能低下。
Objective To investigate the clinical manifestations of pituitary adenomas in adolescence and evaluate the microsurgical efficacy in short-term follow-up（6 months） and long-term follow-up（2 years）. Methods The clinical manifestations of 48 adolescents with pituitary adenomas were reviewed retrospectively. The patients were divided into groups according to pathology or the diameter of the tumors. Macroadenomas（dia 〉 10 mm） was in group A, microadenomas（dia ≤10 mm） was in group B. Short-time（6 months） and long-time（2 years） follow-up were done. The cure rate, control rate and non-cure rate of each group were registered. Results Of the 48 patients, 23 had prolactinomas, 9 had somatotrophinomas, 5 had Cushing＇s disease, 11 had non-functioning adenomas. The cure and control rate in group A was 73.0%, 6 months postoperatively, group B was 90.0 % ; The cure and control rate in group A was 64.8 % 2 years postoperatively, group B was 81.8 %. Microsurgical efficacy of the two groups had significant difference statisticly（P 〈 0.01 ）. Conclusion Microsurgery was a safe and effective and preferential therapy for pituitary adenomas in adolescence. But for macroadenomas, postoperative radiation therapy or assisted drugs therapy was often needed. And radiation therapy should be chosen cautiously to prevent hypopituitarism.
出处
《首都医科大学学报》
CAS
2005年第4期447-450,共4页
Journal of Capital Medical University
基金
国家自然科学基金(30371451)资助项目
关键词
青春期
垂体腺瘤
显微神经外科
adolescence
pituitary adenomas
microneurosurgery
