经蝶窦显微外科切除垂体ACTH腺瘤治疗Cushing病  

Treatment of Cushing's disease by microsurgically transsphenoidal removal of ACTH-secreting pituitary adenomas

作　　者：任祖渊[1] 王维钧[1] 尹昭炎[1] 苏长保[1] 阮伟峰[1] 陆召麟[2] 潘志耆[2] 张洁萍[2] 臧旭[3] 

机构地区：[1]北京协和医院神经外科 [2]北京协和医院内分泌科 [3]北京协和医院病理科

出　　处：《中华神经外科杂志》1989年第1期2-6,共5页Chinese Journal of Neurosurgery

摘　　要：本文报告经蝶窦选择性切除垂体ACTH瘤治疗Cushing病63例的经验,其中ACTH微腺瘤57例,大腺瘤6例。总有效率为90.48％(57例),其中优良级73.1％(46例),进步17.46％(11例);3例无效为4.76％;3例复发为4.76％,无死亡。 本资料说明经蝶窦手术切除ACTH微腺瘤的疗效较高、并发症较少、较安全,应为对库兴病的首选治疗方法。63 patients with Cushing's disease were treated by microsurgically selectively transsphenoidal removal of ACTH pituitary adenomas,including pituitary microadeuomas in 57 cases and macroadenomas in 6, from June 1981 to June 1987. The overall efficient rate were 90.48%(57/63),including excellent 60.32% (38/63), good 12.70% (8/63), improved17.76% (11/63), 3 cases failed(4.76%),and 3 recurred(4.76%), nodeath. Pathologically, the pituitary ACTH adenomas of 74.60% were proved by both light or electronmicroscopically and immunocytochemical stain. The diagnosis to the Cushing's disease, as well as the etiology, the surgical indications, the factors of the effective results and the complications,the factors of the effective results and the complications with their measures of preventions,are discussed. The theraoeutics indicate that microsurgically transsphenoidal exploration for an ACTH adenoma is excellent, lower complications and safer approach, with regarding the first choice in treating these patients in our service.

关 键 词：垂体瘤 蝶窦 显微外科 库兴病 

分 类 号：R586.205[医药卫生—内分泌]