经蝶假性包膜下垂体腺瘤显微切除术后垂体功能评价  

Evaluation of the Pituitary Function after Transsphenoidal Surgery under Pseudocapsule Excision

作　　者：张卓 陈娟[1] 胡峰 徐钰 王俊文[1] 雷霆[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院神经外科,武汉430030

出　　处：《神经损伤与功能重建》2017年第6期529-531,共3页Neural Injury and Functional Reconstruction

基　　金：国家卫计委临床重点专科资助项目;同济医院引领和TOP资助项目

摘　　要：目的:探讨经蝶假性包膜下垂体腺瘤显微切除术对术后垂体功能的影响。方法:收集有完整随访记录的经鼻蝶垂体瘤显微切除术患者156例的临床资料并进行回顾性分析。结果:156例手术病例中,假性包膜103例(66.03%),男30例(29.13%),女73例(70.87%)。其中,术前基础皮质醇低下患者39例,手术后皮质醇恢复正常,术后3 d及3月皮质醇水平均高于术前(P<0.05);术前皮质醇正常61例,手术前后皮质醇水平差异无统计学意义。术后3月影像学检查,假性包膜组肿瘤全切率高于非假性包膜组(P<0.05)。结论:基于假性包膜下的经蝶垂体腺瘤显微切除术可以显著提高肿瘤全切率,促进垂体功能恢复。Objective： To evaluate the pituitary function after transsphenoidal surgery under pseudocapsule ex- cision. Methods： Detailed database of 156 pituitary adenoma patients treated with pseudocapsule-based extracapsular transsphenoidal microsurgery were retrospective analyzed. Results： The total detection rate of pseudocapsule was 103 （66.03%） out of 156, among which 30 （29.13%） cases were found in men,and 73 （70.87%） cases were found in women. There were 39 patients with low cortisol before surgery, and the cortisol returned to nor- mal after surgery. The cortisol levels at 3 days and 3 months after surgery were significantly higher than that be- fore surgery （P〈0.05）. No significant difference were detected in the levels of cortisol before and after surgery in cases with normal cortisol. The total resection rate of adenoma was higher in pseudocapsule group than that in non-pseudocapsule group （P〈0.05）. Conclusion： Pseudocapsule-based extracapsular transsphenoidal microsurgery for pituitary adenomas helps to increase the total tumor resection rate and improve the recovery of pituitary function after surgery.

关 键 词：垂体腺瘤 经蝶显微手术 假性包膜 

分 类 号：R735.1[医药卫生—肿瘤]