神经内镜下经鼻蝶入路垂体瘤切除术联合奥曲肽治疗垂体生长激素腺瘤的临床疗效  

Clinical Efficacy of Neuroendoscopic Endonasal Transsphenoidal Pituitary Adenoma Resection Combined with Octreotide in the Treatment of Patients with Pituitary Growth Hormone Adenoma

作　　者：马昌宝 杨泽君 MA Changbao;YANG Zejun(Department of Neurosurgery,Huaian Hospital of Traditional Chinese Medicine,Huaian 223003,China)

机构地区：[1]江苏省淮安市中医院脑外科,223003

出　　处：《实用心脑肺血管病杂志》2025年第2期104-108,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：江苏省自然科学基金面上项目(BK20211382)。

摘　　要：目的探讨神经内镜下经鼻蝶入路垂体瘤切除术联合奥曲肽治疗垂体生长激素腺瘤的临床疗效。方法选取2021年1月—2023年1月淮安市中医院收治的96例垂体生长激素腺瘤患者作为研究对象,采用随机数字表法将患者分为参照组(n=48)和联合组(n=48)。参照组患者采用神经内镜下经鼻蝶入路垂体瘤切除术治疗,联合组在参照组基础上加用奥曲肽治疗1年。比较两组临床疗效,治疗前及治疗1个月后垂体激素〔血清催乳素(PRL)、促肾上腺皮质激素(ACTH)、生长激素(GH)、胰岛素样生长因子1(IGF-1)〕水平、主要临床症状评分、36项简明健康调查量表(SF-36)各维度评分,并观察两组并发症及随访1年内疾病复发情况。结果治疗1年后,联合组临床疗效优于参照组(P<0.05)。治疗1个月后,联合组血清PRL、ACTH、GH、IGF-1水平及头痛、视力模糊、性功能障碍评分低于参照组(P<0.05)。治疗1个月后,联合组总体健康、躯体角色、躯体疼痛、躯体功能、社交功能、情感角色、心理健康、生命力维度评分高于参照组(P<0.05)。两组并发症总发生率比较,差异无统计学意义(P>0.05)。联合组随访1年内疾病复发率低于参照组(P<0.05)。结论神经内镜下经鼻蝶入路垂体瘤切除术联合奥曲肽治疗垂体生长激素腺瘤的疗效确切,可有效改善患者的垂体功能,减轻症状严重程度,提高生活质量,降低疾病复发率,且具有一定安全性。Objective To investigate the clinical efficacy of neuroendoscopic endonasal transsphenoidal pituitary adenoma resection combined with octreotide in the treatment of patients with pituitary growth hormone adenoma.Methods A total of 96 patients with pituitary growth hormone adenoma admitted to Huaian Hospital of Traditional Chinese Medicine from January 2021 to January 2023 were selected,and they were divided into the reference group(n=48)and the combined group(n=48)according to random number table method.Patients in the reference group were received neuroendoscopic endonasal transsphenoidal pituitary adenoma resection,and patients in the combined group were received octreotide for 1 year based on the reference group.Clinical efficacy,hypophyseal hormone levels[serum prolactin(PRL),adrenocorticotropic hormone(ACTH),growth hormone(GH),insulin-like growth factor 1(IGF-1)],main clinical symptoms scores,and scores of each dimension in 36-Item Short Form Health Survey(SF-36)before treatment and at 1 month after treatment were compared between the two groups,and incidence of complications and disease recurrence within 1 year of follow-up of the two groups were observed.Results At 1 year after treatment,the clinical efficacy in the combined group was better than that in the reference group(P<0.05).At 1 month after treatment,the serum levels of PRL,ACTH,GH and IGF-1,and scores of headache,blurred vision and sexual dysfunction in the combined group were significantly lower than those in the reference group(P<0.05).At 1 month after treatment,scores of overall health,physical role,body pain,physical function,social function,emotional role,mental health and vitality dimensions in the combined group were significantly higher than those in the reference group(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).The disease recurrence rate within 1 year of followup in the combined group was lower than that in the reference group(P<0.05).Conclusion Neuroendoscopic endon

关 键 词：分泌生长激素的脑垂体腺瘤 奥曲肽 经鼻蝶入路垂体瘤切除术 神经内镜 治疗结果 

分 类 号：R736.4[医药卫生—肿瘤]