探讨垂体瘤患者手术前后垂体功能变化及其影响因素  

Investigation of changes in pituitary functions of patients with pituitary adenoma before and after surgery and influential factors

作　　者：张胡金[1] 

机构地区：[1]西安市中心医院神经外科,陕西西安710003

出　　处：《中国实验诊断学》2016年第2期204-206,共3页Chinese Journal of Laboratory Diagnosis

摘　　要：目的分析垂体瘤患者手术前后垂体功能变化特征,探讨影响因素,总结管理经验。方法 2011年-2014年10月,进行手术治疗并获得随访35例垂体瘤,对比垂体功能变化情况,并进行因素分析。结果术后6例垂体功能减退,19例甲状腺功能亢进(8例术前正常),15例肾上腺轴功能不全(7例正常),6例尿崩(术前排尿均正常);术前、术后首日、术后1个月、术后6个月,TSH、TT4、FT4、ACTH8am、COR8am水平差异具有统计学意义(P<0.05);垂体功能恢复57.14%,恢复者侵袭性比重、年龄、病程低于未恢复者,差异具有统计学意义(P<0.05)。结论垂体瘤患者手术前后会发生垂体功能变化,与手术直接相关,部分患者需药物治疗,垂体功能异常变化与肿瘤侵袭性、患者年龄与病程等因素有关。Objective To investigate characteristics of changes in pituitary functions of patients with pituitary adenoma before and after surgery,influential factors and sum up management experiences. Methods Changes in pituitary functions of 35 patients with pituitary adenoma before and after surgery who received pituitary adenoma resection in our hospital and were followed up over a period from 2011 to October, 2014 were investigated and the influential factors were analyzed. Results After operation, 6 patients had hypopituitarism, 19 patients had hyperthyroidism （8 patients had normal thyroid function before operation）, 15 patients had adrenal insufficiency （7 patients had normal adrenal function before operation）,6 patients had diabetes insipitus （all had normal urination （micturition） before operation）. At the day before operation, first day after operation,the 1st month after operation and the 6th month after operation, in the serum levels of TSH,TT4, FT4, ACTH8am and COR8am, there were all significant differences among the patients（all P〈0. 05）. The pituitary functions of 57. 14% of patients recovered to normal, and among those patients whose pituitary functions had recovered,the invasiveness rate of the tumor,age of the patient and course of the disease were all lower than those whose pituitary functions hadn＇t recovered and there were significant differences （all P〈 0.05）. Conclusion The pituitary functions of the patients with pituitary adenoma change after operation,which is relat- ed to the operation directly,a part of the patients need pharmacotherapy（medication）. Abnormal changes in pituitary function maybe associated with invasiveness of the tumor,age of the patient and course of the disease.

关 键 词：垂体瘤 垂体功能 手术 影响因素 

分 类 号：R736.4[医药卫生—肿瘤]