200例垂體腺瘤患者的臨床特征及治療回顧
發(fā)布時間：2019-01-06 15:48
【摘要】：目的：回顧200例垂體腺瘤患者年齡、性別以及手術方式等臨床資料,探討垂體腺瘤的臨床特征、診斷及外科治療,以此為基礎逐步積累本地區(qū)垂體腺瘤的經驗,隨時調整治療策略,達到更滿意的治療效果。方法：收集2012年9月～2014年9月昆明醫(yī)科大學附屬第一醫(yī)院神經外科200例病例進行回顧分析,所有入選病例均經術后病理檢查明確為垂體腺瘤。統計資料內容包括有一般資料、臨床表現、內分泌檢查結果、影像學檢查結果、病理學檢查結果、手術入路選擇、術后并發(fā)癥以及處理等。結果：200例患者中男性93例,女性107例,年齡分布18歲～72歲,以20～50居多。就診癥狀主要包括視力視野受損、頭痛頭暈、閉經、泌乳等,另外有少數肢端肥大體形、向心性肥胖者,病程1月至10年不等。病理類型以多激素細胞性腺瘤(26.5%)和泌乳素激素細胞性腺瘤(25.5%)最多。初步診斷依靠CT或MRI所見。200例患者中,184例患者行“單鼻孔經蝶垂體瘤切除術”,95例術前視力及視野障礙者,術后改善者82例,發(fā)生術后并發(fā)癥107例；其他16例患者行“經顱垂體瘤切除術”,術前10例有視力及視野障礙,術后改善者5例,發(fā)生術后并發(fā)癥14例。外科手術后癥狀緩解率為91.5%,治愈率為85.5%,復發(fā)率為4.0%,死亡率0.5%。結論：1.我院所處區(qū)域女性垂體腺瘤患者多于男性,20～50歲的患者發(fā)病率較高�；颊呷朐褐饕呐R床首發(fā)癥狀為頭昏頭痛、視力下降和視野缺損,其余為內分泌異常,男性患者主要為性功能減退,女性患者為閉經和泌乳。2.術后病理資料顯示病理類型以多激素分泌型腺瘤和泌乳素腺瘤居多。除泌乳素細胞性瘤女性的發(fā)病率明顯高于男性外,其他各型垂體瘤并無明顯性別差異。3.經統計學證實,患者臨床癥狀的改善以及并發(fā)癥的發(fā)生與手術方式有明顯相關性。經鼻蝶入路手術相對經顱手術來說,具有損傷小、手術時間短、并發(fā)癥少、術后康復時間短、手術死亡率極低等優(yōu)點,可作為絕大多數垂體腺瘤患者的首選治療方法
[Abstract]:Objective: to review the clinical data of 200 patients with pituitary adenoma, including age, sex and surgical methods, and to explore the clinical features, diagnosis and surgical treatment of pituitary adenomas, and to gradually accumulate the experience of pituitary adenomas in our region. Adjust the treatment strategy at any time to achieve a more satisfactory therapeutic effect. Methods: from September 2012 to September 2014, 200 cases of neurosurgery in the first affiliated Hospital of Kunming Medical University were retrospectively analyzed. Statistical data include general data, clinical manifestations, endocrine findings, imaging findings, pathological findings, surgical approach options, postoperative complications and management. Results: among the 200 patients, 93 were male and 107 were female. The age distribution ranged from 18 to 72 years old. The symptoms included visual field impairment, headache and dizziness, amenorrhea, lactation, and a few patients with hypertrophy and obesity. The course of disease ranged from 1 month to 10 years. The most common pathological types were polyhormone cell adenoma (26. 5%) and prolactin cell adenoma (25. 5%). Among the patients who were diagnosed by CT or MRI, 184 patients were treated with single nostril transsphenoidal pituitary adenoma resection, 95 patients with visual acuity and visual field disorder before operation, 82 patients with postoperative improvement and 107 patients with postoperative complications. The other 16 patients underwent "transcranial pituitary adenectomy". 10 cases had visual acuity and visual field disorder before operation, 5 cases were improved after operation, and 14 cases had postoperative complications. The remission rate of symptoms was 91.5%, the cure rate was 85.5%, the recurrence rate was 4.0%, and the mortality was 0.5%. Conclusion: 1. The incidence of pituitary adenoma in female patients was higher than that in male patients aged 20 ~ 50 years. The main clinical symptoms of the patients were dizziness headache, vision loss and visual field defect, the rest were endocrine abnormalities, the male patients were mainly sexual dysfunction, and the female patients were amenorrhea and lactation. 2. Postoperative pathological data showed that polyhormone secreted adenoma and prolactin adenoma were the main pathological types. Except for the incidence of prolactinomyoma in women was significantly higher than that in men, there was no significant gender difference in other types of pituitary adenomas. Statistically, the improvement of clinical symptoms and the occurrence of complications were significantly correlated with the operative methods. Compared with transcranial surgery, transsphenoidal approach has the advantages of less injury, shorter operative time, less complications, shorter postoperative recovery time and lower operative mortality. It can be used as the first choice for most pituitary adenoma patients.
【學位授予單位】：昆明醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R736.4
本文編號：2402996
[Abstract]:Objective: to review the clinical data of 200 patients with pituitary adenoma, including age, sex and surgical methods, and to explore the clinical features, diagnosis and surgical treatment of pituitary adenomas, and to gradually accumulate the experience of pituitary adenomas in our region. Adjust the treatment strategy at any time to achieve a more satisfactory therapeutic effect. Methods: from September 2012 to September 2014, 200 cases of neurosurgery in the first affiliated Hospital of Kunming Medical University were retrospectively analyzed. Statistical data include general data, clinical manifestations, endocrine findings, imaging findings, pathological findings, surgical approach options, postoperative complications and management. Results: among the 200 patients, 93 were male and 107 were female. The age distribution ranged from 18 to 72 years old. The symptoms included visual field impairment, headache and dizziness, amenorrhea, lactation, and a few patients with hypertrophy and obesity. The course of disease ranged from 1 month to 10 years. The most common pathological types were polyhormone cell adenoma (26. 5%) and prolactin cell adenoma (25. 5%). Among the patients who were diagnosed by CT or MRI, 184 patients were treated with single nostril transsphenoidal pituitary adenoma resection, 95 patients with visual acuity and visual field disorder before operation, 82 patients with postoperative improvement and 107 patients with postoperative complications. The other 16 patients underwent "transcranial pituitary adenectomy". 10 cases had visual acuity and visual field disorder before operation, 5 cases were improved after operation, and 14 cases had postoperative complications. The remission rate of symptoms was 91.5%, the cure rate was 85.5%, the recurrence rate was 4.0%, and the mortality was 0.5%. Conclusion: 1. The incidence of pituitary adenoma in female patients was higher than that in male patients aged 20 ~ 50 years. The main clinical symptoms of the patients were dizziness headache, vision loss and visual field defect, the rest were endocrine abnormalities, the male patients were mainly sexual dysfunction, and the female patients were amenorrhea and lactation. 2. Postoperative pathological data showed that polyhormone secreted adenoma and prolactin adenoma were the main pathological types. Except for the incidence of prolactinomyoma in women was significantly higher than that in men, there was no significant gender difference in other types of pituitary adenomas. Statistically, the improvement of clinical symptoms and the occurrence of complications were significantly correlated with the operative methods. Compared with transcranial surgery, transsphenoidal approach has the advantages of less injury, shorter operative time, less complications, shorter postoperative recovery time and lower operative mortality. It can be used as the first choice for most pituitary adenoma patients.
【學位授予單位】：昆明醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R736.4
【參考文獻】
相關期刊論文 前3條
1 盧海濤,孫曉川,鄭履平,李峰;經蝶垂體瘤術后尿崩癥的臨床分析[J];山西醫(yī)科大學學報;2003年06期
2 王守森,王如密,鄭兆聰,荊俊杰,魏梁鋒,趙琳,陳宏頡,張錫增;垂體腺瘤的手術入路選擇(附鞍區(qū)顯微解剖研究及113例報告)[J];中國微侵襲神經外科雜志;2005年07期
3 蔡瑜,趙衛(wèi)國,沈建康,卞留貫,成侃;垂體大腺瘤經蝶顯微手術84例[J];中國微創(chuàng)外科雜志;2005年08期
相關碩士學位論文 前1條
1 許悅;經蝶入路切除垂體瘤術后常見問題的臨床分析[D];大連醫(yī)科大學;2008年
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