垂体腺瘤经鼻蝶手术与伽玛刀治疗后激素变化比较  

Comparison of the blood hormone levels after gamma knife radiosurgery and transnasal-sphenoidal surgery on pituitary adenomas

作　　者：刘海涛[1] 陈群[1] 许建新[2] 

机构地区：[1]镇江市第一人民医院伽玛刀中心,江苏镇江212003 [2]山西医科大学第二医院神经外科,山西太原030001

出　　处：《中华神经外科疾病研究杂志》2008年第2期119-122,共4页Chinese Journal of Neurosurgical Disease Research

摘　　要：目的探讨经鼻蝶手术和伽玛刀治疗后对激素变化的影响。方法对203例符合入选标准的垂体腺瘤患者随机分为经鼻蝶手术组和伽玛刀治疗组，分别采取手术和伽玛刀治疗，抽血检查并记录术前和治疗后每3月激素水平。根据分泌激素类型、肿瘤最大径和治疗后不同时间段分组统计，组间比较用t检验。结果①按分泌激素不同分类，垂体腺瘤伽玛刀治疗组和经鼻蝶手术组之间无统计学差异。②不同时段分组，12个月以内手术组疗效高于伽玛刀治疗组。12—24月内手术与伽玛刀治疗效果相当。超过24个月以后伽玛刀组疗效高于经鼻蝶手术组。③按肿瘤最大径分组，对于肿瘤直径〈1cm者，手术与伽玛刀疗效无差别。对于肿瘤直径在1～3cm之间者，伽玛刀组疗效高于经鼻蝶手术组。当肿瘤直径〉3cm时，经鼻蝶手术组与伽玛刀治疗组间疗效无分别。结论①对于分泌不同激素的垂体瘤，经鼻蝶手术和伽玛刀疗效相当。②治疗12个月内，手术疗效明显高于伽玛刀，超过24个月后伽玛刀疗效高于手术，12～24个月之间两种治疗措施间疗效无明显差别。③肿瘤直径〈1cm者，两种疗效俱佳且无差别，当〉3cm时，两组间疗效无差异，疗效均不理想。Objective To investigate the changes of blood hormoon levels on the patients with pituitary adenoma after the transnasal-sphonoidial surgery or GBamma Knife radiosurgery treatment. Methods A total of 203 patients with pituitary adenomas, which were divided into transnasal-sphonoidial surgery group and Gamma Knife group randomly, underwent the correspondent treatment. rlhe blood hormone levels after the surgery were recorded every 3 months, and the data of hormone type, tumor diameter and seasonahty were analyzed by SPSS 13. 0 software. T-test was used in every group.Results （1） There was no significant difference among divea＇se types of pituitary adenomas （t =0.140, P 〉0.05）. （2） There was difference between two groups within 12 months after treatment with better therapy effect in transnasalsphenoidal surgery group than in Gamma Knife group （P 〈0.05）; but no difference between two groups from 12 to 24 months after treatment （P〉0.05）. （3） There was no difference between two groups in cases of tumor diameter 〈1 cm （t =0.971, P〉0.05） or〉3 cm （t =0.010, P〉0.05）. Difference occurred between two groups in cases of tuner diameter from 1 cm to 3 cm （t =5.526, P 〈0.05）. Conclusion （1） The therapy effect is identical between two groups on the patients with different secreting hormone pituitary adenomas. （2） Surgery is more effective than the Gamma Knife in early 12 months after treatment and the Gammar Knife is better than the surgery after 24 months. Therapy effects are the same between 12 months to 24 months after treatmeant （3） For cases of tuner diameter 〈 1 can, the effects of Gamma knife radiosurgery and the transnasal-sphenoidal surgery are the same. For cases of tumor diameter 〈 1 cm and 〉 3 cm, Knife has the better therapy effect than surgery. For cases of tumor diameter 〉 3 cm, neither Gamma Knife radiosurgery or the transnasal-sphenoidal surgery get the satisfactory results.

关 键 词：垂体腺瘤 经鼻蝶手术 伽玛刀 激素 

分 类 号：R736.4[医药卫生—肿瘤]