老年无功能性垂体腺瘤的临床特征及显微外科治疗  

Clinical characteristics and microsurgical therapy of non-functional pituitary adenomas in elderly patients

作　　者：赵奕[1] 连伟[1] 幸兵[1] 姚勇[1] 冯铭[1] 王任直[1] 吴焕文[2] Zhao Yi Lian Wei Xing Bing Yao Yong Feng Ming Wang Renzhi Wu Huanwen(Department of Neurosurgery Department of Pathology, Peking Union Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院神经外科,100730 [2]中国医学科学院北京协和医学院北京协和医院病理科,100730

出　　处：《中国微侵袭神经外科杂志》2017年第9期400-403,共4页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的总结分析老年无功能性垂体腺瘤的临床特征、治疗及预后情况。方法回顾性分析106例65岁以上无功能性垂体腺瘤病人的临床资料,均行经鼻蝶窦入路显微外科垂体腺瘤切除术。并对其临床特征、治疗及预后情况进行分析。结果肿瘤全切除80例(75.5%),次全切除10例(9.4%),大部分切除16例(15.1%)。术中脑脊液漏7例,均行术中修补。术后合并脑积水、脑干出血1例,放弃治疗;心肌梗死1例,转心内科治疗后好转;颅内感染2例,迟发性脑脊液漏2例,动眼神经麻痹1例,外展神经麻痹2例,激素水平减低7例,经对症处理后均好转。89例(84.0%)随访时间(38.6±10.6)个月,治愈73例,部分缓解14例,未缓解2例。肿瘤复发16例(15.1%),其中14例行放射治疗,2例于我院行再次手术治疗。结论老年无功能性垂体腺瘤病人经过充分术前评估后可以进行垂体腺瘤手术,多学科联合诊治对老年病人的手术治疗非常有必要。Objective To investigate clinical characteristi cs,treatment and prognosis of non-functional pituitary adenomas in elderly patients.Methods Clinical data of 106 pituitary adenoma patients more than 65 years old were analyzed retrospectively,and microsurgery was performed via transsphenoidal approach.Then,clinical characteristics,treatment and prognosis were studied.Results Total tumor resection was achieved in 80 patients（75.5%）,subtotal resection in 10（9.4%） and partial resection in 16（15.1%）.Leakage of cerebrospinal fluid occurred in 7 patents during the operation,and all were mended.Hydrocephalus and hemorrhage of brain stem occurred in 1 patient postoperatively,and patient families gave up the therapy.Myocardial infarction occurred in 1 patient,and who was transferred to department of cardiology.Other complications included intracranial infection in 2 patients,delayed leakage of cerebrospinal fluid in 2,oculomotor paralysis in 1,abducent paralysis in 2 and lowered hormone level in 7,and all patients improved after expectant treatment.Eighty-nine patients were followed up for 38.6±10.6 months,73 cured,14 got partial remission and 2 had no remission.Tumor recurred in 16 patients（15.1%）,radiological therapy was performed in 14 and re-operation in 2.Conclusions Surgery can be performed in the elderly patients with non-functional pituitary adenoma after full preoperative evaluation,and multiple department treatment is necessary to the elderly people.

关 键 词：垂体腺瘤 无功能性 入路 经鼻蝶窦 显微外科手术 老年人 

分 类 号：R736.4[医药卫生—肿瘤]