功能性垂体腺瘤的手术治疗结果
Vlastimil Novak1, Lumir Hrabalek1, Jan Schovanek2
1Department of Neurosurgery, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic.
概括
功能性垂体腺瘤的鼻腔外科手术使58.6%的患者的激素过量产生正常化. 其他患者需要额外的治疗来实现缓解,重点是手术.
科学领域:
- 神经外科 神经外科
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
背景情况:
- 功能性垂体腺瘤是由于激素综合征导致显著的发病率和死亡率的原因.
- 手术干预是治疗这些瘤的基石.
- 鼻腔外科手术为下垂体腺瘤治疗提供了一种微创的方法.
研究的目的:
- 评估功能性垂体腺瘤的鼻腔外科手术的结果.
- 评估手术在正常化荷尔蒙过度产生的有效性.
- 根据瘤类型和荷尔蒙综合征来确定缓解率.
主要方法:
- 对58名患有功能性垂体腺瘤 (ACTH,GH,PLR) 的患者进行了回顾性分析.
- 所有患者都接受过鼻腔外科手术.
- 进行了手术前和手术后的内分泌学评估和成像.
主要成果:
- 58.6%的患者在手术后实现了荷尔蒙正常化.
- 缓解率因激素而异:产生ACTH的78.6%,产生GH的51.4%,产生PRL的腺瘤的57.1%.
- 宏腺瘤在ACTH组 (100%) 的缓解率高于微腺瘤 (72.8%).
结论:
- 鼻腔外科手术在正常化荷尔蒙过分分泌方面是有效的,在相当一部分功能性垂体腺瘤患者中是有效的.
- 药物治疗和放射治疗是实现非响应者的荷尔蒙缓解的必要辅助.
- 手术结果受过度产生的特定激素和瘤大小的影响.
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