手术治疗垂体瘤的疗效分析及生活质量评估  

Clinical Observation and Quality of Life in Patients with Pituitary Adenoma Treated by Microneurosurgery

作　　者：周培志[1] 周玉萍[1] 姜倩[2] 马卫朝[1] 彭里磊[1] 董伟[1] 姜曙[1] 

机构地区：[1]四川大学华西医院神经外科,成都610041 [2]四川大学华西公共卫生学院卫生统计教研室

出　　处：《华西医学》2010年第8期1450-1452,共3页West China Medical Journal

基　　金：四川省科技攻关基金资助项目(06SG0471)

摘　　要：目的分析手术治疗垂体瘤患者长期临床恢复以及生活质量改善情况。方法回顾性分析2007年12月-2008年9月手术治疗的103例垂体瘤患者术前以及术后长期随访资料,使用SF-36量表对术前、术后患者生活质量进行评估,分析手术治疗前后患者症状、激素水平恢复情况以及生活质量改善情况,并进一步分析肿瘤大小、侵袭程度对术后生活质量的影响。结果术后头痛症状消失52例,视力改善76例,其他症状具有不同程度改善;术后SF-36生活质量评估结果显示,患者除精神健康外的7个维度(生理机能、生理职能、躯体疼痛、一般健康状况、精力、社会功能、情感职能)均有明显改善(P<0.05),不同肿瘤大小及侵袭程度的患者术后生活质量评分均无统计学意义(P>0.05),垂体功能完全恢复者生活质量评分高于垂体功能低下者(P<0.05)。结论显微手术治疗垂体瘤患者可明显改善患者的一般症状、提高患者的生活质量,单纯肿瘤的大小和侵袭程度对术后生活质量的影响程度较小,术后垂体功能的恢复程度明显影响患者的生活质量,垂体瘤术后患者的激素长期替代治疗尚需进一步加强。Objective To analyze the long-term clinical recovery and quality of life （ QoL） in patients with pituitary adenoma treated by microneurosurgery. Methods The clinical data of 103 patients undergoing microneurosurgery from December 2007 to September 2008 were retrospectively analyzed,health-related questionnairs （ SF-36） were used to assess the QoL. The post-surgery recovery of symptoms,endocrine function,and QoL were compared with those of pre-surgery,then the correlation between tumor size,invasive behavior,and QoL were analyzed. Results Headache disappeared in 52 patients. Visual symptoms improved in 76 patients. Other symptoms were also improved. Seven concepts （ physical functioning,role physical,bodily pain,general health,vitality,social functioning,role emotioning） were improved after surgery （ P〈 0. 05）. The eight health concepts of SF-36 showed no significant difference between patients with different tumor size and invasive behavior （ P 〉0. 05）. Differences were considered statistically significant between normal and abnormal pituitary function groups after surgery（ P〈 0. 05） in all concepts. Conclusion Microneurosurgical treatment can improve the general symptoms and the QoL. The tumor size and invasion have little influence on the QoL after surgery,but the improvement of hormone deficiency has influence on the QoL significantly. More attention should be given to the long-term hormone replacement therapy after the pituitary adenoma surgery.

关 键 词：垂体瘤 生活质量评估 显微神经外科手术 

分 类 号：R736.4[医药卫生—肿瘤] R616.3[医药卫生—临床医学]