【摘要】 目的评价经鼻蝶入路手术和伽玛刀对垂体生长素腺瘤的治疗效果和特点,并分析预后的相关影响因素。方法回顾性分析经鼻蝶入路手术切除生长素腺瘤病例30例、单纯伽玛刀治疗47例和手术联合应用伽玛刀治疗25例的临床资料,并统计分析其不同方法治疗效果和并发症以及术前服用药物、激素水平等相关影响因素。结果所有病例平均随访56.5个月,手术组、伽玛刀组和联合组治愈率分别为53.3%、51.1%和64.0%,有效控制率分别为83.3%、87.2%和92.0%;手术组肿瘤复发率为6.67%。结论显微外科手术和伽玛刀均是治疗垂体生长素腺瘤的有效方法。伽玛刀治疗垂体腺瘤中术前服用生长抑素类似物和GH水平是预后的明显影响因素。伽玛刀治疗后5年内不建议接受进一步的放射和手术治疗,在此期间激素水平仍有下降的趋势。更多还原

【Abstract】 Objective To evaluate the therapeutic efficacy of transsphenoidal surgery and gamma knife radiosurgery for growth hormone-producing pituitary adenomas and to investigate factors that might affect outcomes.Methods We retrospectively analyzed the data of 102 cases.Among them,30 cases were treated with transsphenoidal surgery,47 cases with gamma knife radiosurgery and 25 cases (combined subgroup) by transsphenoidal and gamma knife radiosurgery.Pretreatment somatostatin drug administration and GH level were also studied.Results Follow-up of hree subgroups lasted for a median of 56.5 month afters the treatment.The cure rate of transsphenoidal surgery,gamma knife radiosurgery and combined subgroup was 53.3%,51.1% and 64.0%,respectively;the effective control rate was 83.3%,87.2% and 92.0%,respectively. The recurrence rate was 6.67% in transsphenoidal subgroup.Conclusion The microsurgery and gamma knife are both effective methods for pituitary adenomas.Preradiosurgery somatostatin drug administration and GH level significantly affect the prognosis of patients.Patients with GH-producing pituitary adenomas should not undergo further radiation therapy and surgery for at least 5 years after radiosurgery,for GH level continues decreasing to normal over that interval.更多还原