【摘要】 本文报告经手术及病理证实的复发性垂体腺瘤36例。复发的临床表现主要为视力视野改变。内分泌障碍及头痛。复发时间最短3个月,最长10年,平均4.1年;年龄≥40岁组平均为5.2年,<40岁组为2.5年(P<0.05);第一次手术肿瘤大部或次全切除者平均为5.2年,部分切除者为1.2年(P<0.01);手术加放疗者平均为5.1年,手术未放疗者为2.2年(P<0.05)。再次手术经额入路29例,改良翼点入路2例,经蝶入路5例。术后视力视野恢复及头痛缓解27例,症状无改善5例,死亡4例(11％)。随访21例,随访期7月～10年,其中肿瘤未复发16例,复发4例,死亡1例。文章就复发性垂体腺瘤的诊断及治疗问题进行了讨论。更多还原

【Abstract】 Thirty-six cases of recurrent pituitary adenoma verified by surgery and pathology are reported. The main presenting symptoms were visual changes, endocrine abnormalities and headache, which reappeared 3 months to 10 years (mean 4.1 years) after the initial operation. Average recurrent interval was 5.2 years in the patients over 40 years of age, 2.5 years in patients below 40 (p<0.05), 5.2 years in patients with subtotal removal of tumor and 1.2 years in partial resection of tumor (p<0.05), 5.1 years in patients underwent operation and radiotherapy, and 2.2 years in patients having operation only (p<0.05). Second operation was performed in 29 cases through transfrontal approach, 2 cases via the modified pterional approach and 5 cases transsphenoidal. After the second operation, recovery of vision and relief of headache were found in 27 cases, no improvement in 5 and death in 4 (surgical mortality 11%). Twenty-one cases were followed for 7 months to 10 years, 16 of them was in excellent or good state, 4 suffered from recurrence and 1 died of diabetes. The diagnosis and management of recurrent pituitary adenomas are discussed.更多还原