影响非功能性垂体神经内分泌瘤手术患者激素结果的因素:一项前性观察性研究
Harsimran Singh1, Achal Sharma1, Madhur Choudhary1
1Department of Neurosurgery, Sawai Man Singh Medical College, Jaipur, Rajasthan, 302004, India.
Neurosurgical review
|December 26, 2024
概括
切除非功能性垂体瘤的手术切除可以导致激素轴功能障碍. 更大的瘤直径和体积显著预测这种功能障碍,超过三分之一的患者在手术后显示出改善的荷尔蒙功能.
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:
- 非功能性垂体神经内分泌瘤 (NF-PitNET) 的手术切除与激素轴 (HA) 功能障碍有关.
- 手术后HA功能障碍的预测因素,特别是大型和巨大的NF-PitNET,仍在争论中.
研究的目的:
- 为了评估NF-PitNET患者的术后激素功能.
- 为了确定影响HA功能障碍的因素在内镜外科切除后.
主要方法:
- 对50名接受内镜切除NF-PitNET的患者进行前性观察性研究.
- 瘤直径和体积的放射性评估.
- 术前和术后 (7天,90天) 的荷尔蒙评估.
主要成果:
- 90天后,36%的患者恢复了HA功能,34%保持不变,30%的情况恶化.
- 皮质醇,ACTH,GH和LH水平显著增加; 益生菌素显著下降.
- 男性的性别,瘤体积和瘤直径是术后HA功能障碍的显著预测因素.
结论:
- 瘤直径和体积是NF-PitNET中术后HA功能障碍的显著预测因素.
- 内镜切除结果显示HA功能变化的复杂模式,超过三分之一的患者有所改善.
- 新发的无味糖尿病是最常见的并发症 (30%).
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