经蝶窦显微手术与伽玛刀治疗泌乳素微腺瘤的疗效对比  

Comparative study of transsphenoidal microsurgery and gamma knife radiosurgery in the treatment of prolactin-secreting microadenoma

作　　者：苏海波[1] 刘灵慧[1] 陈善成[1] 赖睿佳[1] 

机构地区：[1]暨南大学附属第一医院神经外科,广州510630

出　　处：《中国微侵袭神经外科杂志》2011年第5期200-202,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的对比经蝶窦显微外科手术与伽玛刀治疗泌乳素微腺瘤的疗效。方法回顾性分析104例泌乳素微腺瘤的临床资料。采用经蝶窦显微手术(手术组)50例,伽玛刀治疗(伽玛刀组)54例。通过比较两组临床症状缓解率、泌乳素水平、并发症发生率及MRI表现,综合评价两组疗效。结果临床症状缓解率手术组为94%,伽玛刀组为92.6%,两组差异无统计学意义(P>0.05)。与术前比较,两组术后初期泌乳素水平均明显改善(P<0.01);与伽玛刀组比较,手术组术后泌乳素水平下降更快(P<0.01)。并发症发生率手术组为30.0%,伽玛刀组为13.0%,两组差异具有统计学意义(P<0.05)。结论经蝶手术与伽玛刀治疗泌乳素微腺瘤各有优缺点。经蝶手术泌乳素下降快;伽玛刀治疗的并发症少,且症状轻微,相对更安全。Objective To compare the therapeutic effects of transsphenoidal microsurgery（TSM） and gamma knife radiosurgery（GKR） for prolactin-secreting microadenoma.Methods Clinical data of 104 patients with prolactin-secreting microadenoma were analyzed retrospectively.TSM was performed in 50 cases（TSM group） and GKR in 54（GKR group）.The clinical effects of TSM and GKR were evaluated according to the following aspects： clinical symptom relief rate,serum prolactin level,complication rate and MRI images.Results The clinical symptom relief rate was 94% in TSM group and 92.6% in GKR group,and there was no significant difference between TSM group and GKR group（P0.05）.Compared with preoperation,the serum prolactin levels in two groups significantly decreased postoperatively（P0.01）.Compared with GKR group,the serum prolactin levels decreased more quickly in TSM group（P0.01）.The complication rate was 30.0% in TSM group and 13.0% in GKR group,and there was a significant difference between the two groups（P0.05）.Conclusions TSM and GKR for prolactin-secreting microadenoma have their respective advantages and disadvantages.TSM can make the serum prolactin levels decrease more quickly,while GKR can get less and milder complications,thus being safer than TSM.

关 键 词：催乳素瘤 显微外科手术 放射疗法 

分 类 号：R736.4[医药卫生—肿瘤]