垂体生长激素腺瘤经蝶入路手术预后因素分析

doi:10.3969/j.issn.1006-7795.2011.05.022

首都医科大学学报 ›› 2011, Vol. 32 ›› Issue (5): 688-691.doi: 10.3969/j.issn.1006-7795.2011.05.022

垂体生长激素腺瘤经蝶入路手术预后因素分析

毕智勇, 贾旺, 贾桂军

首都医科大学附属北京天坛医院神经外科,北京 100050

收稿日期:2011-03-29 修回日期:1900-01-01 出版日期:2011-10-21 发布日期:2011-10-21
通讯作者: 贾桂军

Analysis of factors influencing effect of transsphenoidal microsurgery for growth hormone-secreting pituitary adenoma

BI Zhi-yong, JIA Wang, JIA Gui-jun

Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China

Received:2011-03-29 Revised:1900-01-01 Online:2011-10-21 Published:2011-10-21

摘要/Abstract

摘要： 目的评价垂体生长激素腺瘤经蝶手术的疗效和分析影响手术疗效的相关因素。方法回顾性分析106例资料完整经蝶手术治疗的垂体生长激素腺瘤病人的临床资料,根据肿瘤大小、术前生长激素水平、侵袭性等进行分类。随访术后激素水平、影像学检查评价手术疗效。结果垂体生长激素腺瘤患者进行经蝶手术后总缓解率为72.6%,Ⅰ级缓解率为84.2%,Ⅱ级为82.6%,Ⅲ级为64.7%,Ⅳ级为14.4%。Knosp 0、1、2、3、4级术后患者缓解率分别为89.7%、80.6%、66.7%、45.5%、0.0%。结论患者术前生长激素(growth hormone,GH)>30 μg/L、肿瘤侵袭度＞Ⅱ级是影响预后的危险因素;随肿瘤发展对患者颈内动脉包裹程度增加,术后缓解率显著下降。生长激素腺瘤患者缓解率和肿瘤大小、侵袭性、术前GH水平显著相关。

关键词: 垂体腺瘤, 肢端肥大症, 经蝶手术, 生长激素

Abstract: Objective To evaluate the therapeutic effect of transsphenoidal microsurgery for growth hormone-secreting pituitary adenoma(GHPA) and analyze the correlative factors influencing the effect. Methods The clinical data of 106 patients who underwent transsphenoidal microsurgery for GHPA were retrospectively analyzed. The tumors were classified according to tumor size, preoperative GH levels, and invasion etc. Based on the criterion of cure of acromegaly, postoperative hormone level and imaging examination were used to evaluate the post-operative outcomes. Results Total remission rate was 72.6%, and grades Ⅰ, Ⅱ, Ⅲ, and Ⅳ adenomas were 84.2%, 82.6%, 64.7%, and 14.4%, respectively. But according to Knosp grading,the remission rate of 0~4 grade were 89.7%, 80.6%, 66.7%, 45.5% and 0.0%, respectively. Conclusion The prognoses were related to the size of the adenomas, the preoperative level of GH and invasiveness of GH-secreting adenomas.

Key words: pituitary adenomas, acromegaly, transsphenoidal surgery, growth hormone

中图分类号:

R 651

毕智勇;贾旺;贾桂军. 垂体生长激素腺瘤经蝶入路手术预后因素分析[J]. 首都医科大学学报, 2011, 32(5): 688-691.

BI Zhi-yong;JIA Wang;JIA Gui-jun. Analysis of factors influencing effect of transsphenoidal microsurgery for growth hormone-secreting pituitary adenoma[J]. Journal of Capital Medical University, 2011, 32(5): 688-691.

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垂体生长激素腺瘤经蝶入路手术预后因素分析

Analysis of factors influencing effect of transsphenoidal microsurgery for growth hormone-secreting pituitary adenoma

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