在一次性下垂体手术失败后,如何管理库辛氏病?
Nidhi Agrawal1, Sandrine A Urwyler2, Sonal Mehta1
1Division of Endocrinology, Diabetes and Metabolism, New York University Langone Medical Center, New York, NY 10016, United States.
European journal of endocrinology
|September 14, 2024
概括
转腺切除术是库辛病的首要治疗方法. 本综述侧重于二线疗法,如重复手术,药物治疗和放射治疗,用于初始垂体外科手术后持续的高皮质醇症.
科学领域:
- 内分泌学 在内分泌学.
- 神经外科 神经外科
- 在瘤学瘤学.
背景情况:
- 库辛病是一种罕见的内分泌系统疾病,是由于皮质醇的过度产生引起的.
- 转腺切除术是导致库辛病的脑垂体瘤的标准一线手术治疗方法.
- 治疗失败需要对替代治疗策略进行评估.
研究的目的:
- 审查和讨论不成功的原发性垂体外科手术后库辛病的二线治疗选择.
- 突出了可用的医疗疗法的扩大作用和类型.
- 概述双边上腺切除术的指示.
主要方法:
- 对库辛病的治疗方法的文献综述.
- 分析二线治疗的疗效和适应症.
- 专注于转腺瘤切除术失败后的选择.
主要成果:
- 第二线选择包括重复手术,药物治疗和放射治疗.
- 医学疗法包括针对垂体的药物,类固醇合成抑制剂和葡萄糖皮质体受体对抗剂.
- 双边上腺切除术仅用于耐火病例或当快速皮质醇正常化至关重要时.
结论:
- 逐步的方法对于管理库辛病至关重要.
- 医疗治疗在管理持续性或复发性疾病方面发挥着越来越重要的作用.
- 治疗选择取决于疾病的严重程度,患者的因素和治疗反应.
相关概念视频
Adrenal Gland Disorders
1.4K
Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
1.4K
Chronic Pancreatitis II: Collaborative Care
71
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
71
Hypoglycemia and Glucagon
216
Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
216
Peptic Ulcer Disease V: Surgical Management and Nursing Care
246
Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
Surgical Interventions for Peptic Ulcer Disease
Surgical Interventions for Peptic Ulcer Disease
246
Hypothalamic-Pituitary Axis
59.7K
The response to stress—be it physical or psychological, acute or chronic—involves activation of the Hypothalamic-Pituitary-Adrenal (HPA) axis. The HPA axis is part of the neuroendocrine system because it involves both neuronal and hormonal communication. Its function is to regulate homeostatic systems—metabolic, cardiovascular, and immune—providing the necessary means to respond to a stressor.
59.7K


