经蝶骨内镜显微手术治疗垂体腺瘤对术后激素的影响  

Endoscopic transsphenoidal microsurgery for pituitary adenomas affects the post-operational hormone:a Meta-analysis

作　　者：徐文中[1] 郭志波[1] 李建军[1] 丁健[1] 

机构地区：[1]河南科技大学第二附属医院神经外科,河南洛阳471000

出　　处：《中华神经外科疾病研究杂志》2017年第3期244-248,共5页Chinese Journal of Neurosurgical Disease Research

摘　　要：目的探索经蝶骨内镜辅助切除垂体腺瘤对患者生长激素(GH)、催乳素(PRL)、促肾上腺皮质激素(ACTH)的影响。方法网页检索Pub Med、Web of Science和Embase数据库,获取有关内镜切除垂体腺瘤的文献,根据文献纳入与排除标准进行筛选,经两位工作人员分别提取文献内资料,用Stata14.0软件进行数据分析。结果经文献筛选后,最终纳入7篇符合要求的文献,包括1080个患者。Meta分析结果:GH[危险度差值(RD)=0.18;95%可信区间(CI):0.06~0.27];PRL(RD=0.20;95%CI:0.14~0.27);ACTH(RD=0.02;95%CI:0.14~0.17)。小腺瘤和大腺瘤两组间,GH和PRL的术后恢复率对比差异有统计学意义(P<0.01)。结论内镜治疗垂体腺瘤术后,ACTH恢复率在小腺瘤和大腺瘤间没有明显统计学差异,GH和PRL的恢复率在小腺瘤要高于大腺瘤。Objective The effect of transspheneidal endoscopic microsurgery for pituitary adenoma on the growth hormone （GH）, prolactin （PRL）, and adrenocorticotropic hormone （ACTH） were discussed. Methods The literatures about endoscopic resection of pituitary adenoma by searching PubMed, Web of Science and Embase databases were collected and assessed and screened according to the literature inclusion and exclusion criteria. All the data in the literatures were extracted by two staff members and were analyzed using Stata 14. 0 software. Results After screening literature, eventually seven met the requirements of literature included, including 1080 patients. Meta- analysis results： GH [ risk differences （RD） = 0.18; 95% confidence intervals（CA） ： 0.06 -0.27 ] ; PRL （ RD ） = 0. 20; 95% CA ： 0. 14 - 0. 27） ; ACTH （ RD = 0. 02; 95% CI： 0. 14 - 0. 17）. The difference of post-operative recovery rate of GH and PRL between small adenoma and large adenoma groups was statisticaUy significant （P 〈0.01）. Conclusion After endoscopic treatment of pituitary adenoma, there is no statistically significant difference in ACTH recovery rate between small and large adenomas. Recovery rate of GH and PRL in small adenomas is higher than that of large adenomas.

关 键 词：垂体腺瘤 生长激素 催乳素 促肾上腺皮质激素 荟萃分析 

分 类 号：R562.2[医药卫生—呼吸系统]