经单鼻孔蝶窦入路垂体PRL腺瘤手术疗效分析

发布时间：2018-04-25 06:47

本文选题：催乳素腺瘤 + 催乳素　；参考：《广西医科大学》2017年硕士论文

【摘要】：目的:探讨经单鼻孔蝶窦入路切除垂体PRL腺瘤的手术治疗效果。方法:回顾性分析35例在我院神经外科接受经单鼻孔蝶窦入路垂体PRL腺瘤切除手术患者的临床资料。检测患者术前及术后血PRL水平,并对可能影响手术疗效的因素如肿瘤大小、肿瘤切除程度及侵袭性进行统计学分析。结果:男性发病率要低于女性,男女比率为1:1.19;占位效应引起的最常见的临床表现为头痛(34.29%)、视觉障碍(40%);内分泌异常导致男性患者主要表现为性功能下降(18.75%),女性主要表现为闭经(73.68%)、泌乳(21.05%)、不孕(26.32%);男女患者术前PRL水平存在差异(P=0.047);男性患者与女性患者肿瘤大小存在差异(P=0.009);术前PRL水平影响术后第1天PRL水平(P=0.033);手术肿瘤全切患者比未全切患者治愈率高(P=0.006);肿瘤大小影响手术治疗效果(P=0.004);术后第1天的血PRL20ng/ml与PRL20ng/ml,患者复发率存在差异(P=0.031);侵袭性与非侵袭性PRL腺瘤患者的术后复发率比较差异有统计学意义(P=0.004)。结论:男性患者就诊时PRL水平更高肿瘤更大;术前PRL200ng/ml患者术后治愈率比术前PRL200ng/ml患者要低;手术全切患者术后治愈率比未全切患者要高;催乳素微腺瘤患者比大腺瘤患者术后治愈率要高;术后第1天PRL20ng/ml比PRL20ng/ml患者复发率要低,术后第1天PRL水平可作为预测复发的指标之一;侵袭性PRL腺瘤比非侵袭性PRL腺瘤患者复发率高,侵袭性PRL腺瘤术后需行综合治疗。
[Abstract]:Objective: to evaluate the effect of transsphenoidal resection of pituitary PRL adenoma. Methods: the clinical data of 35 patients undergoing transsphenoidal pituitary PRL adenectomy in our hospital were retrospectively analyzed. The serum PRL levels were measured before and after operation, and the factors that might affect the outcome of the operation were analyzed statistically, such as tumor size, tumor resection degree and invasion. Results: the incidence rate of males was lower than that of females. The most common clinical manifestations caused by the space-occupying effect were headache 34.29 and visual disturbance 400.Endocrine abnormality led to the decrease of sexual function in male patients (18.75), and the main manifestations of women were amenorrhea (73.68), lactation (21.05%), infertility (26.32 2). There were significant differences in preoperative PRL levels (P < 0.047); difference in tumor size between male and female patients (P < 0.009); influence of preoperative PRL level on PRL level on the first day after operation (P < 0.033); the cure rate of total tumor resection patients was higher than that of non-total resection patients (P < 0.006); The recurrence rate of PRL20ng/ml was different from that of PRL 20ng / ml on the first day after operation, and the recurrence rate of invasive and non-invasive PRL adenoma was significantly different from that of non-invasive PRL adenoma. Conclusion: the PRL level of male patients was higher than that of PRL200ng/ml patients, the cure rate of PRL200ng/ml patients before operation was lower than that of PRL200ng/ml patients before operation, the cure rate of patients with total operation was higher than that of patients without total resection. The postoperative cure rate of prolactin microadenoma patients was higher than that of macroadenoma patients, the recurrence rate of PRL20ng/ml was lower than that of PRL20ng/ml patients on the first day after operation, and the level of PRL on the first day after operation could be used as a predictor of recurrence. The recurrence rate of invasive PRL adenoma is higher than that of non-invasive PRL adenoma. The invasive PRL adenoma needs comprehensive treatment after operation.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R736.4

【参考文献】