孙晓川 郑履平 霍 刚 唐文渊 吕孟达 重庆医科大学附一院神经外科(400016) 中国神经精神疾病杂志 1999 0 25 4


    关键词：垂体腺瘤；经蝶手术；手术入路；远期疗效 期刊 zgsjjsjbzz 0 论著与学术交流 fur -->


    

【摘要 】 目的 分析影响垂体腺瘤预后的因素并探讨治疗方法的选择。方法 对经手术治疗的308例垂体腺瘤中的155例进行了2年以上的随访和远期疗效评价，分别就肿瘤大小、肿瘤类型、手术方式、肿瘤切除范围以及放射治疗对预后的影响作了分析。结果 垂体微腺瘤和小腺瘤的疗效优于大腺瘤和巨大腺瘤，分泌性腺瘤的疗效优于非分泌性腺瘤，肿瘤全切除的疗效优于次全切除和部分切除，大腺瘤经蝶入路的疗效优于经额入路。结论 肿瘤大小和切除范围是影响预后的主要因素。微、小腺瘤选择经蝶入路最佳，大腺瘤尽量采用经蝶入路，巨大腺瘤则是以鞍上下联合入路为宜。

Evaluation of long-term therapeutic efficacy andselection of treatments of pituitary adenomas.

Sun Xiaochuan, Zheng Luping, Huo Gang, Tang Wenyuang andNu Mengda.

    Department of Neurosurgery, The First Affiliated Hospital, Chongqing University of MedicalSciences, Chongqing. 400016. Tel:023-68806492

【Abstracts 】ObjectiveToinvestigate the factors relating to the prognosis of pituitary adenomas and to discuss theselection of treatments.Methods Of 308 patients who underwent resections of pituitaryadenomas, 155 cases had been followed up for more than two years and the long-termtherapeutic efficacy was evaluated. The influences of size and pathologicl classificationof tumors, surgical approaches, extent of removal of tumors and radiotherapy on prognosiswere analyzed respectively.Results The treatment results of microadenomas andsmall-adenomas were better than those of large-adenomas and macroadenomas.The treatmentsof functional adenomas also showed better outcomes than those of non-secreting adenomas.The better prognoses were obtained with total resection of tumors than with subtotal andpartial removal of tumors. The operative effect on large-adenomas through transphenoidalapproach was superior to transfrontal approch.Conclusions The main factors relating toprognosis of pituitary adenomas are size of tumors and extent of surgical excision.Transphenoidal procedure is the preferred way for microadenomas and should be adopted forlarge-adenomas as frequently as possible, while combined supra-infrasellar approach is arational choice for macroadenomas.

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