儿童和青春期垂体腺瘤的经蝶手术治疗  

Transsphenoidal microsurgical treatment of pituitary adenoma in children and adolescents

作　　者：骆纯[1] 卢亦成[1] 胡国汉[1] 姚志强[1] 马驰原[1] 

机构地区：[1]上海市神经外科研究所上海长征医院神经外科,200003

出　　处：《中华神经医学杂志》2005年第4期362-364,共3页Chinese Journal of Neuromedicine

基　　金：上海市科委重点项目(044119658)上海市卫生局医苑新星培养计划(2002049)

摘　　要：目的探讨年龄小于17岁的儿童及青春期垂体腺瘤的诊断及其经蝶窦显微外科手术治疗。方法本组20例(垂体PRL腺瘤7例,ACTH腺瘤5例,GH腺瘤4例,无功能腺瘤4例)均行经蝶窦显微外科垂体腺瘤切除术。结果肿瘤全切除18例,部分切除2例;随访8个月-8年,治愈75%,缓解25%,复发5%;常见并发症为尿崩症(25%)和电解质紊乱(25%)。结论经蝶窦垂体腺瘤切除术是治疗儿童及青春期垂体腺瘤的安全有效的方法。Objective To discuss the diagnosis and transsphenoidal surgical treatment of pituitary adenomas under 17 years old. Methods 20 cases of adenomas, including 7 PRL adenomas, 5 ACTH adenomas, 4 GH adenomas, 4 nonfunctioning pituitary adenomas, were all performed with microsurgical resection through transphenoidal approach. Results The common manifestations included endocrine disturbance (80%), visual disturbance (35%) and headache (20%). Menoschesis or menstruation disturbance is common for the female. The total resection was achieved in 18 cases and partial resection in 2. Postoperative follow-up were 8 months to 8 years in all patients. The cure rate was 75%; relieving rate was 25%; recurrent rate 5%. The most common complications were diabetes insipidus (25%) and electrolyte disturbance (25%). Conclusion The transsphenoidal microsurgery is safe and successful for pituitary adenomas in children and adolescents.

关 键 词：青春期 儿童 垂体腺瘤切除术 外科手术治疗 ACTH腺瘤 蝶窦显微外科 垂体PRL 无功能腺瘤 肿瘤全切除 电解质紊乱 常见并发症 部分切除 经蝶窦 尿崩症 

分 类 号：R736.4[医药卫生—肿瘤]