男性垂体泌乳素腺瘤的显微手术治疗  

Microsurgical treatment of male prolactionma

作　　者：骆纯[1] 卢亦成[1] 孙克华[1] 丁学华[1] 胡国汉[1] 楼美清[1] 陈菊样[1] 吴小军[1] 姚志强[1] 

机构地区：[1]上海市神经外科研究所,第二军医大学长征医院神经外科,上海市200003

出　　处：《中华显微外科杂志》2005年第2期109-111,共3页Chinese Journal of Microsurgery

摘　　要：目的分析总结男性垂体泌乳素腺瘤的诊断和治疗特点。方法对7年间33例男性垂体泌乳素腺瘤的临床特点和肿瘤的病理、内分泌、影像学及治疗特点进行分析。患者平均年龄39.2岁。临床表现以性功能、视力视野障碍多见。患者平均血清泌乳素水平为(2405.57±39.85)ng/ml,肿瘤直径为(29.9±10.4)mm,75.76%的肿瘤为侵袭性。结果显微手术全切除27例,次全切除6例。经手术及药物治疗后,患者泌乳素降至正常23例(69.70%,),明显下降7例(21.21%);26例性功能障碍患者14例恢复正常或改善;18例视力下降的患者16例视力恢复正常或改善;17例视野缺损的患者14例视野恢复正常或改善。结论男性泌乳素腺瘤侵袭性生长多见,泌乳素水平高,采取显微神经外科手术尽可能切除肿瘤,并辅助药物治疗可以取得满意效果。Objective To investigate the diagnostic and therapeutic features of prolactionma in men. Methods Clinical manifestation, pathologic, endocrinolgical, radiographic and therapeutic features in 33 male prolactionma patients in 7 years were included. The average age of the patients was 39.2. The major clinical manifestation were sexual and visual disfunction. Average serum prolactin were (2405.57±39.85)mg/ml, average longitudinal diameter of the tumors was (29.9±10.4)cm,and 75.76% of the tumors were invasive. Results Total tumor removal was achieved in 27 cases, and subtotal removal in 6 case. After surgery and/or drug therapy,the average serum prolactin decreased to normal in 23 cases (69.70%) ,significantly decreased in 7 (21.21%) cases;14 of 26 patients improved in sexual function; 16 of 18 patients improved in eyesight and 14 of 17 in visual field. Conclusion Male prolactionomas were usally invasive, and serum prolaction levels are high. Microsurgical treatment should be used to remove the tumour totally, adjuvant drug therapy might be useful, and satisfactory, results might be achieved.

关 键 词：垂体泌乳素腺瘤 显微手术治疗 男性 显微神经外科手术 辅助药物治疗 诊断和治疗 血清泌乳素 手术全切除 性功能障碍 侵袭性生长 临床特点 平均年龄 临床表现 肿瘤直径 次全切除 视力恢复 视力下降 视野缺损 患者 内分泌 

分 类 号：R736.4[医药卫生—肿瘤] R739.41[医药卫生—临床医学]