垂体瘤患者经鼻蝶垂体瘤术后垂体功能减退的相关影响因素及防范措施分析  

Analysis of related influencing factors and preventive measures of hypopituitosis in patients with hypopituitosis after transnasal sphenohypopituitosis

作　　者：黄新妹 张国妹[1] 谢燕 Huang Xinmei;Zhang Guomei;Xie Yan(The Second Affiliated Hospital of Nanchang University,Nanchang,Jiangxi 330000,China)

机构地区：[1]南昌大学第二附属医院,江西南昌330000

出　　处：《首都食品与医药》2023年第8期46-48,共3页Capital Food Medicine

摘　　要：目的探讨垂体瘤患者经鼻蝶垂体瘤术后垂体功能减退的相关影响因素及防范措施。方法回顾性分析南昌大学第二附属医院收治的169例垂体瘤手术患者临床资料,统计垂体功能减退发生率,并依据垂体功能减退情况分为发生组与未发生组,收集两组多方面基础资料,包括年龄、性别、体质量指数、病程、垂体瘤大小、垂体瘤类别、术前是否合并垂体功能低下、病史、颅内压。先对上述资料开展单因素分析,待获得有统计学差异的项目后再行Logistic回归分析。结果169例经鼻蝶入路垂体肿瘤切除术患者术后实验室检查结果中,血清游离甲状腺素水平(13.20±2.11)pmol/L、皮质醇水平(4.56±0.55)μg/dl、促甲状腺素水平(12.10±1.38)mU/L、黄体生成素水平(2.63±0.79)mU/ml、促卵泡生成素水平(2.71±0.62)mU/ml、睾酮水平(2.51±0.38)μg/L,其中有63例发生垂体功能减退,发生率为37.28%(63/169);单因素分析显示年龄、性别、体质量指数、垂体瘤大小、垂体瘤类别、高血压史、癫痫史与垂体功能减退发生无关,差异无统计学意义(P>0.05);两组病程、术前是否合并垂体功能低下、颅内压与垂体功能减退发生有关,差异有统计学意义(P<0.05);多因素分析显示,病程<3个月、术前合并垂体功能低下、颅内压>200mmH2O为影响经鼻蝶垂体瘤术后垂体功能减退的独立危险因素(P<0.05且OR>1)。结论垂体瘤患者经鼻蝶垂体瘤术后垂体功能减退发生率较高,受病程、术前合并垂体功能低下、颅内压高低等因素影响,临床需以此制定针对性预防措施,以改善患者预后。Objective To investigate the related factors and preventive measures of hypopituitosis in patients with pituitary tumor after transnasal sphenohypopituitosis.Methods The clinical data of 169 patients with pituitary tumor surgery admitted to our hospital were retrospectively analyzed.The incidence of hypopituitosis was statistically analyzed,and the patients were divided into two groups according to hypopituitosis and non-hypopituitosis.Various basic data of the two groups were collected.Including age,sex,body mass index,course of disease,size of pituitary tumor,type of pituitary tumor,preoperative combination of hypopituitarism,medical history and intracranial pressure.Univariate analysis was carried out on the above data first,and Logistic regression analysis was performed after items with statistical differences were obtained.Results Among 169 patients undergoing pituitary tumor resection through nasal sphenoidal approach,Serum levels of free thyroxine(13.20±2.11)pmol/L,cortisol(4.56±0.55)μg/dl,thyrotropin(12.10±1.38)mU/L,luteinizing hormone(2.63±0.79)mU/ml and follicle-stimulating hormone(2.71±0.62)mU/ml and testosterone levels(2.51±0.38)μg/L,among which 63 cases had hypopituitarism,the incidence was 37.28%(63/169).Univariate analysis showed that age,sex,body mass index,pituitary tumor size,type of pituitary tumor,history of hypertension and history of epilepsy had no statistical significance in the occurrence of hypopituitism(P>0.05).The course of disease,preoperative combination of hypopituitarism,intracranial pressure and hypopituitarism were related(P<0.05).Multivariate analysis showed that the course of disease<3 months,preoperative combined with hypopituitosis,and intracranial pressure>200mmH2O were independent risk factors for postoperative hypopituitosis of nasal sphenohypopituitosis(P<0.05 and OR>1).Conclusion The incidence of hypopituitosis in patients with pituitary tumor after transnasal sphenohypopituitosis is relatively high,which is affected by the course of the disease,preoperative comb

关 键 词：垂体瘤 经鼻蝶入路垂体肿瘤切除术 垂体功能减退 影响因素 

分 类 号：R736.4[医药卫生—肿瘤]