【摘要】 目的分析总结经蝶垂体瘤切除术对生长激素腺瘤的疗效观察。方法回顾254例垂体生长激素腺瘤的资料。结果平均病程3.5年。侵袭性腺瘤20例,非侵袭性腺瘤234例。术后复发4例,视力视野改变3例,γ刀治疗后3例。手术采用经单鼻孔或口鼻蝶改良入路,肿瘤全切除和次全切除率85%,生长激素水平恢复正常率87%,血糖改善率81%,死亡率0.8%。50例平均随访54.5个月,生活自理47例,复发4例。术后放疗垂体功能低下发生率62.1%。结论垂体生长激素腺瘤,临床以面容改变、肢端肥大、继发性血糖增高、头痛等为主要症状,经蝶显微手术为首选治疗。需注意放疗后垂体功能低下的并发症。更多还原

【Abstract】 Objective To analyze the curative effect of transsphenoidal surgery treating the GH-secreting pituitary adenoma.(Methods)254 cases of GH-secreting pituitary adenoma are reviewed.Results The mean present history was 3.5 years.The cases include 20 invasive adenoma and 234 non-invasive adenoma.Among the patients,4 patients were recurrence after operation,3 patients accompanied by the change of visual acuity and field,3 had γ-knife previously.The operative approach includes trans-single nares and trans-sphenoidal sinus.The rate of total excision and subtotal excision is 85%.In 87% patients the level of GH hormone return to be normal.In 81% patients the blood glucose ameliorate.The mortality is 0.8%.The mean follow-up of 51 patients are 43.5 months,47 patients self-care and 4 recurrence.50% patiens accompanied hypopituitarism after getting postoperative radiotherapy.Conclusion The major symptoms of GH-secreting pituitary adenoma include physiognomy change,acromegaly,secondary hyperglycaemia and headache.Transsphenoidal surgery is the primary therapy.The complication of hypopituitarism after radiotherapy should be payed attention.更多还原