术中生长激素测定在垂体生长激素腺瘤经蝶手术疗效判断中的作用  

The role of intraoperative growth hormone measurement in the evaluation of the efficacy of transsphenoid surgery for pituitary growth hormone-producing adenoma

作　　者：王汉盆 石清泉 卞留贯[2] 孙青芳[2] 

机构地区：[1]浙江省丹山市人民医院,316004 [2]上海交通大学附属瑞金医院,200025

出　　处：《实用医学杂志》2008年第16期2821-2823,共3页The Journal of Practical Medicine

摘　　要：目的:探讨垂体生长激素(GH)腺瘤经蝶手术中GH的变化以及在手术疗效判断中的作用。方法:回顾分析19例肢端肥大症患者,其中微腺瘤10例,大腺瘤9例;均采用经蝶手术,术中分别于鞍底硬膜切开时和肿瘤切除完毕鞍底修复时采血,计算GH下降率。结果:术后随访期内GH<2.0ng/mL的有15例,缓解率78.9%。统计学分析显示术中GH的下降率与术后缓解之间呈明显负相关。结论:术中GH的动态观察有助于早期判断手术效果,若能及时快速测定GH,将有助于提高缓解率。Objective To intraoperatively observe the dynamic changes of growth hormone （GH） and to evaluate the efficacy of transsphenoid surgery by detecting GH levels. Methods The data on 19 patients who developed acromegaly （10 with pituitary microadenoma and 9 with macroadenoma） were retrospectively analyzed. Transsphenoid surgery was performed on all the patients to remove the tumor. GH level was measured at the time of opening the dura mater of the sellar floor and repairing the dura mater after removal of the tumor, respectively. The intraoperative GH reduction rate was calculated. Results In the postsurgical follow-up, GH level decreased to less than 2.0 ng/mL in 15 patients, with a remission rate of 78.9%. The intraoperative GH reduction rate was closely associated with the postoperative remission. Conclusions Intraoperative GH measurement is valuable in the early evaluation of the efficacy of transsphenoid surgery. A prompt GH detection can enhance the remission rate.

关 键 词：垂体肿瘤 生长激素 经鼻蝶手术 

分 类 号：R736.4[医药卫生—肿瘤] R575[医药卫生—临床医学]