垂体瘤孕妇的诊治与围分娩期管理  

Treatment and management of pituitary tumor during pregnancy

作　　者：冉晨曦 沈如飞 廖明钰 廖倩 周玲 张玉玲 隆敏 Ran Chenci;Shen Rufei;Liao Mingyu;Liao Qian;Zhou Ling;Zhang Yuling;Long Min(Department of Endocrinology,The Second Affiliated Hospital(Xinqiao Hospital)of Army Medical University,Chongqing 400037,China;Department of Endocrinology,The First Affiliated Hospital(Xinan Hospital)of Army Medical University,Chongqing 400037,China)

机构地区：[1]中国人民解放军陆军军医大学第二附属医院内分泌科,重庆400037 [2]中国人民解放军陆军军医大学第一附属医院内分泌科,重庆400037

出　　处：《中华妇幼临床医学杂志（电子版）》2023年第4期487-491,共5页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：重庆市中青年医学高端人才项目(20220505)。

摘　　要：女性孕期激素水平会发生显著变化,垂体正常组织和垂体瘤组织均易受激素水平改变的影响。对于垂体瘤女性患者,孕期垂体激素水平变化,除了增加肿瘤生长风险外,还会影响孕妇和胎儿健康;对垂体瘤孕妇采取不同的治疗或干预手段,均可影响其整个孕期的自然进程。由于妊娠状态的特殊性,使得孕期对垂体瘤的诊断颇具挑战性,由垂体激素水平(催乳素、生长激素、皮质醇等)异常继发的不良妊娠结局亦可能增加。因此,孕期垂体瘤的诊治及随访十分重要。本文重点分析各型垂体瘤患者的孕期特点和注意事项,旨在为这类患者孕期个体化管理提供指导。During pregnancy, there will be significant changes in endogenous hormones level, and pituitary tissues are susceptible to these changes. For women with pituitary tumor, changes in pituitary hormones during pregnancy will not only increase the risk of tumor growth, but also affect the health status of them and their fetuses. Different treatments or interventions during pregnancy can also affect the natural course of pregnancy in patients with pituitary tumors. The specificity of pregnancy status makes the diagnosis of pituitary tumors during pregnancy challenging, which leads to an increase in adverse pregnancy outcomes secondary to abnormal pituitary hormone levels such as prolactin, growth hormone, cortisol, etc.. Therefore, the diagnosis, treatments and follow-up of pituitary tumors during pregnancy are very important. This article focuses on analyzing the pregnancy characteristics and precautions of patients with various types of pituitary tumors, in order to provide guidance for the individualized management of such patients during pregnancy.

关 键 词：垂体肿瘤 妊娠 垂体激素类 疾病管理 催乳素瘤 分泌生长激素的脑垂体腺瘤 垂体ACTH分泌过多 孕妇 

分 类 号：R736.4[医药卫生—肿瘤]