CAJ | 학술논문

目的评估垂体泌乳素(PRL)腺瘤的侵袭性对经鼻蝶窦显微外科手术近期疗效的影响.方法收集并综合分析昆明医学院第一附属医院微创神经外科首次住院治疗且资料完整的33例PRL腺瘤患者的临床资料,分别检测术前和术后第3天、术后1个月血清PRL水平,按照Wilson改良Hardy分类方法判断肿瘤侵袭性.所有患者均由同一手术者进行经鼻蝶窦显微外科手术治疗,术后全部获得随访,随访时间为1～12个月.疗效评定标准:①治愈:激素水平正常,临床症状消失,随访肿瘤未复发；②好转:激素水平正常或下降50％以上,临床症状改善；③无效:激素水平下降不到50％或维持原水平,临床症状未改善.结果本组资料33例PRL腺瘤患者,男8例,女25例；侵袭性腺瘤12例,非侵袭性腺瘤21例.侵袭性与非侵袭性PRL腺瘤患者的术后好转率比较差异无统计学意义(P＞0.05).PRL＜ 200 μg/L的患者与≥200 μg/L的患者术后治愈缓解率比较差异无统计学意义(P＞0.05).结论近期手术疗效可能无侵袭性差异.
목적 평고수체비유소(PRL)선류적침습성대경비접두현미외과수술근기료효적영향.방법 수집병종합분석곤명의학원제일부속의원미창신경외과수차주원치료차자료완정적33례PRL선류환자적림상자료,분별검측술전화술후제3천、술후1개월혈청PRL수평,안조Wilson개량Hardy분류방법판단종류침습성.소유환자균유동일수술자진행경비접두현미외과수술치료,술후전부획득수방,수방시간위1～12개월.료효평정표준:①치유:격소수평정상,림상증상소실,수방종류미복발；②호전:격소수평정상혹하강50％이상,림상증상개선；③무효:격소수평하강불도50％혹유지원수평,림상증상미개선.결과 본조자료33례PRL선류환자,남8례,녀25례；침습성선류12례,비침습성선류21례.침습성여비침습성PRL선류환자적술후호전솔비교차이무통계학의의(P＞0.05).PRL＜ 200 μg/L적환자여≥200 μg/L적환자술후치유완해솔비교차이무통계학의의(P＞0.05).결론 근기수술료효가능무침습성차이.
Objective To assess the effect of the tumor invasiveness of prolactinomas on the recent effects of transsphenoidal microsurgical operation.Methods The clinical datas of 33 initial treated cases of prolactin(PRL)adenomas were collected and analyzed.The serum PRL levels before operation and that within the first 3 days,30 days following surgery were detected.The invasiveness of pituitary adenomas were judged according to Hardy’ s classification scheme modified by Wilson.All patients received transsphenoidal microsurgical treatment performed by one operator and followed up for 1-12 months.Clinical evaluation criteria:①Cure:normalization of hormonal levels,disappearence of clinical symptoms,and no recurrence in follow-up period.②Remission:clinical symptoms were sharply improved,and hormonal levels normalized or reduced more than 50％.③ Persistence:hormonal levels reduced less than 50％,and clinical symptoms were not improved.Results There were 33 patients with PRL-secreting pituitary adenomas,8 males and 25 females,12 patients with invasive adenomas and 21 patients with noninvasive adenomas.The remission rate between the patients with invasive adenomas and the patients with non-invasive adenomas had no statistically significant difference(P ＞0.05).The postoperative remission rate of patients with PRL values ＜ 200 μg/L was no significantly lower than that of patients with pRL values ≥200 μg/L(P ＞ 0.05).Conclusions The recent effects of operation are not significantly different with the invasiveness of tumor.