垂体腺瘤的远期疗效分析和治疗选择探讨  

Evaluation of long term therapeutic efficacy and selection of treatments of pituitary adenomas.

作　　者：孙晓川[1] 郑履平[1] 霍刚[1] 唐文渊[1] 吕孟达[1] 

机构地区：[1]重庆医科大学附一院神经外科,400016

出　　处：《中国神经精神疾病杂志》1999年第4期204-207,共4页Chinese Journal of Nervous and Mental Diseases

摘　　要：目的　分析影响垂体腺瘤预后的因素并探讨治疗方法的选择。方法　对经手术治疗的３０８ 例垂体腺瘤中的１５５ 例进行了２ 年以上的随访和远期疗效评价，分别就肿瘤大小、肿瘤类型、手术方式、肿瘤切除范围以及放射治疗对预后的影响作了分析。结果　垂体微腺瘤和小腺瘤的疗效优于大腺瘤和巨大腺瘤，分泌性腺瘤的疗效优于非分泌性腺瘤，肿瘤全切除的疗效优于次全切除和部分切除，大腺瘤经蝶入路的疗效优于经额入路。结论　肿瘤大小和切除范围是影响预后的主要因素。微、小腺瘤选择经蝶入路最佳，大腺瘤尽量采用经蝶入路，巨大腺瘤则是以鞍上下联合入路为宜。s Objective To investigate the factors relating to the prognosis of pituitary adenomas and to discuss the selection of treatments.Methods Of 308 patients who underwent resections of pituitary adenomas, 155 cases had been followed up for more than two years and the long term therapeutic efficacy was evaluated. The influences of size and pathologicl classification of tumors, surgical approaches, extent of removal of tumors and radiotherapy on prognosis were analyzed respectively.Results The treatment results of microadenomas and small adenomas were better than those of large adenomas and macroadenomas.The treatments of functional adenomas also showed better outcomes than those of non secreting adenomas. The better prognoses were obtained with total resection of tumors than with subtotal and partial removal of tumors. The operative effect on large adenomas through transphenoidal approach was superior to transfrontal approch.Conclusions The main factors relating to prognosis of pituitary adenomas are size of tumors and extent of surgical excision. Transphenoidal procedure is the preferred way for microadenomas and should be adopted for large adenomas as frequently as possible, while combined supra infrasellar approach is a rational choice for macroadenomas.

关 键 词：垂体肿瘤 腺瘤 外科手术 远期疗效 

分 类 号：R736.4[医药卫生—肿瘤]