【作者】 徐广军；

【导师】 赵丛海；

【作者基本信息】 吉林大学 ， 临床医学， 2014， 硕士

【摘要】 目的：评价垂体生长激素腺瘤手术治疗疗效，探索分析影响垂体生长激素腺瘤经蝶手术治疗疗效的相关因素。方法：回顾性研究吉林大学中日联谊医院神经外一科，2009年6月至2014年1月收治的30例垂体生长激素腺瘤患者。患者均行经蝶垂体腺瘤切除术。对这些患者的术前生长激素水平、肿瘤大小及侵袭性、年龄、性别、血型等进行分类，随访术后患者血清GH水平及影像学检查等，对手术疗效进行评价，通过统计分析，探索分析影响垂体生长激素腺瘤经蝶手术治疗疗效的相关因素。结果：进行经蝶手术治疗的垂体生长激素腺瘤患者的总缓解率为73.3%；Ⅰ级缓解率为50.0%,Ⅱ级缓解率为93.3%，Ⅲ级缓解率为54.5%，Ⅳ及Ⅴ级总缓解率为50.0%。术前GH＜10μg/L的患者，缓解率为100%；术前GH水平10-30μg/L的患者，缓解率为86.7%；术前GH＞30μg/L的患者，缓解率为45.5%。结论：垂体生长激素腺瘤患者缓解率和肿瘤大小、侵袭性、术前GH水平显著相关，而和年龄、性别及血型无明显关联。术前生长激素(growth hormone，GH)水平＞30μg/L及肿瘤侵袭度大小分级≥Ⅲ级是影响垂体生长激素腺瘤经蝶手术预后的危险因素。更多还原

【Abstract】 Objective: To evaluate the therapeutic effect of growthhormone-secreting pituitary adenoma (GHPA) after transsphenoidalmicrosurgery treatment and analyze the correlative factors influencingthe effect.Methods: A retrospective analysis was performed using the clinical dataof30GHPA patients undergoing transsphenoidal microsurgy treatmentin212pituitary adenomas patients who were treated in1st departmentof neurosurgery of The China-Japan Union Hospital of Jilin Universityfrom June2009to January2014. According to tumor size, preoperativeGH levels, invasion, blood type, sex, age etc, the tumors were classifiedinto different groups. Based on the criterion of cure of acromegaly,postoperative hormone level and imaging examination were used toevaluate the outcomes after transsphenoidal microsurgery treatment.Result: Total remission rate was73.3%, and gradeⅠ, gradeⅡ, gradeⅢ,grade ⅣandⅤ adenomas were50.0%,93.3%,54.5%and50.0%.The remission rate of preoperative GH level<10μg/L,10-30μg/L and >30μg/L were100%,86.7%and45.5%.Conclusion: The prognoses were related to the size of the adenomas,the preoperative GH level and invasiveness of GH-secreting adenomasbut not to age, sex, or blood type. The preoperative GH level>30μg/Land the level of size and invasiveness≥level Ⅲ were the risk factorsto the prognosis of growth hormone-secreting pituitary adenoma(GHPA) undergoing transsphenoidal microsurgery treatment更多还原