摘要
目的探讨囊性垂体泌乳素大腺瘤的治疗方法和临床效果。方法回顾性分析33例囊性垂体泌乳素大腺瘤病人的临床资料。采用经单鼻孔蝶窦入路切除肿瘤,根据术后复查血清泌乳素水平决定是否联合溴隐亭综合治疗。结果全切除26例,次全切7例。术后1周复查,血清泌乳素恢复正常19例,14例未恢复正常,联合口服溴隐亭治疗。14例联合药物治疗病人中,11例泌乳素水平恢复正常,余3例泌乳素水平未恢复正常,但均〈100 ng/ml,临床症状缓解,未行进一步处理。随访时间6~36个月,平均16个月。术后恢复正常未服药19例病人中,5例复发,采取联合药物治疗后泌乳素水平恢复正常。结论经单鼻孔蝶窦入路切除垂体腺瘤具有安全、简便、微创等优点,可以作为囊性泌乳素大腺瘤的首选治疗方式,如单纯手术无法达到内分泌治愈或术后复发,联合溴隐亭综合治疗是一种较为理想的治疗方案。
Objective To explore the treatment method and clinical efficacy for cystic macroprolactinoma. Methods Clinical data of33 patients with cystic macroprolactinoma were analyzed retrospectively. All the tumors were removed by microsurgery via single nostril transsphenoidal approach. Combined bromocriptine treatment was performed according to the serum prolactin level after surgery. Results Total tumor removal was achieved in 26 patients and subtotal in 7. The serum prolactin level returned to normal in19 patients and remained abnormal in 14 who then received the combined bromocriptine treatment. Of the 14 patients, the serum prolactin level returned to normal in 11. The prolactin level of the remaining 3 patients was abnormal but less than 100 ng/ml and the symptom was relieved, therefore no further therapeutic measures were administered. All the patients were followed up for 6 to 36 months with the average period of 16 months. Of the 19 patients who underwent surgery without drug treatment, the tumors relapsed in5 patients who received bromocriptine treatment and returned to normal. Conclusions Resection of pituitary adenoma via single nostril transsphenoidal approach is safe, convenient and minimal invasive, therefore, can be recommended as the first therapeutic option for cystic macroprolactinoma. Combined bromocriptine is the ideal choice in patients with abnormal serum prolactin level or recurrence after surgery.
出处
《中国微侵袭神经外科杂志》
CAS
2016年第4期157-159,共3页
Chinese Journal of Minimally Invasive Neurosurgery
关键词
催乳素瘤
囊性
入路
单鼻孔蝶窦
显微外科手术
药物疗法
prolactinoma
cystic
approach
single nostril transsphenoidal
microsurgery
drug therapy
