无功能性垂体腺瘤围手术期内分泌水平的变化及诊断进展  

Nonfunctioning pituitary adenomas perioperative endocrine levels and diagnostic progress

作　　者：李彪[1,2] 田君[1] 王守森[1] 

机构地区：[1]南京军区福州总医院神经外科,福州350025 [2]福建医科大学福总临床医学院

出　　处：《中华脑科疾病与康复杂志（电子版）》2014年第2期41-44,共4页Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）

摘　　要：无功能性垂体腺瘤起源于垂体前叶上皮细胞,约占垂体腺瘤的1/3,大多数患者临床表现为头痛、视物模糊。但是部分患者术前及术后出现垂体功能减退。肿瘤对门静脉及垂体柄的压迫导致垂体前叶缺血坏死是引起垂体功能低下的主要机制,术中操作、肿瘤大小及残留都可导致新发垂体功能低下。术前主要以生长激素缺乏为主,而术后出现各个激素轴的改变。垂体功能减退容易被忽视,仅靠激素基础值的检测诊断远远不够,必要时需行刺激试验确诊。一旦明确垂体功能减退,充足的激素替代治疗能够提高患者的生活质量。Nonfunetioning pituitary adenomas originate in the epithelial cells of the anterior pituitary, which accounts for about 1/3 of pituitary adenomas. The most common clinical symptoms in patients with nonfunetioning pituitary adenomas are headache and visual changes. Some patients present hypopituitarism pre-or postoperation. Portal vein and pituitary stalk are compressed by adenomas and cause ischemic necrosis of the anterior pituitary, which is the main mechanism of hypopituitarism. Growth hormone deficiency is the mainly manifestation in the preoperation, the various hormone axis change in the postoperation. Hypopituitarism is often overlook easily, hormone-based detection and diagnosis alone is not enough, the stimulation test is needed when necessary. Once hypopituitarism is confirmed, adequate hormone replacement therapy can improve the quality of life of patients.

关 键 词：垂体功能减退症 手术期间 诊断 无功能性垂体腺瘤 

分 类 号：R736.4[医药卫生—肿瘤]