垂体瘤质地对术后激素水平的影响  

The Clinic Analysis of the Influence of Pituitary Tumor Texture to Postoperative Hormone

作　　者：期俊辉[1] 余泽然 刘正峤 戴成国[1] 倪炜[2] QI Jun-hui;YU Ze-ran;LIU Zhen-qiao;DAI Cheng-guo;NI Wei(Dept.of Neurosurgery,The 2nd Hospital of Yunnan Province,Kunming Yunnan 650021;Dept.of Neurosurgery,Yunnan Tumour Hospital,Kunming Yunnan 650100,China)

机构地区：[1]云南省第二人民医院神经外科,云南昆明650021 [2]云南省肿瘤医院神经外科,云南昆明650018

出　　处：《昆明医科大学学报》2020年第10期79-84,共6页Journal of Kunming Medical University

基　　金：云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目[2018FE001(-008)]。

摘　　要：目的分析垂体瘤质地对术后激素水平的影响。方法回顾性分析行手术治疗并术后随访1 a以上的垂体瘤资料,其中86例肿瘤质地偏硬的病例(A组),肿瘤质地偏软、卒中、囊性变86例(B组)的病例,分析肿瘤质地与术后激素水平的相关性。结果 A组病例中,术后激素轻度紊乱(仅抗利尿激素分泌不足)86/86例(100%),中度紊乱(抗利尿激素分泌不足+甲状腺激素分泌不足或皮质醇低)的病例38/86例(44%),重度紊乱抗利尿激素分泌不足+甲状腺激素分泌不足+皮质醇低或伴促肾上腺皮质激素低17/86例(20%)。B组术后激素轻度紊乱的有57/86例(66.3%),中度紊乱18/86例(21%),重度紊乱9/86例(10%)。A、B两组对应的三项指标应用卡方检验,轻、中度紊乱P<0.05,有统计学意义,重度紊乱P>0.05,无统计学意义。术后激素恢复方面,A、B两组在2、4、12周抗利尿激素都能很好地恢复,2~4周是恢复高峰期;TSH、FT3、FT4、COR在3个月内逐渐恢复。结论质地偏硬的垂体瘤,术后容易出现激素水平下降。无论质地软硬,抗利尿激素在术后2个月恢复较好,但质地较软组恢复较快。A、B两组术后甲状腺激素,皮质3个月内逐渐恢复。Objective To analyze the effect of pituitary tumor texture on postoperative hormone.Methods The data of pituitary adenomas treated by surgery and followed up for more than one year were analyzed retrospectively, including 86 cases with hard tumor texture(group A),86 cases with soft tumor texture, stroke and cystic change(group B). The correlation between the tumor texture and postoperative hormone levels was analyzed.Results There were 86/86(100%)cases with the mild disorder,38/86(44%)cases with the medium disorder and 17/86(20%)cases with the severe disorder in group A,while in group B,57/86 patients(66.3%) had mild disturbance of hormone, 18/86(21%) had moderate disturbance, and 9/86(10%)had severe disturbance.The results of chi square test showed that mild and moderate disorder(P < 0.05) had the statistical significance,while severe disorder(P > 0.05) had no statistical significance.In the aspect of hormone recovery after the operation, antidiuretic hormone in group A and group B recovered well at 2, 4 and 12 weeks, and the recovery peak was 2-4 weeks;TSH,FT3,FT4 and cor gradually recovered within 3 months. Conclusion The pituitary adenoma with hard texture is prone to the decrease of hormone level after the operation. No matter the texture is soft or hard, the recovery of antidiuretic hormone is better 2 months after the operation, but the recovery of texture is faster than that of the soft group. After the operation, thyroid hormone and cortex gradually recover within 3 months in both groups.

关 键 词：垂体腺瘤 质地 激素 

分 类 号：R739.41[医药卫生—肿瘤]