中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2008年
9期
18-21
,共4页
颅咽管瘤%手术%激素替代治疗
顱嚥管瘤%手術%激素替代治療
로인관류%수술%격소체대치료
Craniopharyngioma%Operation%Hormone replacement therapy
目的 探讨鞍区颅咽管瘤患者的临床特点,手术前后神经内分泌激素变化规律,为颅咽管瘤患者内分泌激素监控和更好地替代治疗、进一步实施教育提供依据.方法 回顾性分析183例颅咽管瘤患者临床表现、手术前及手术后不同时期内分泌激素变化等的临床资料.结果 患者术后甲状腺、肾上腺、性腺激素(泌乳素除外)测定较术前均下降,差异有统计学意义(P＜0.05或＜0.01);术后10 d与术后3 d比较,甲状腺(除T4外)、肾上腺、性腺激素水平虽有好转,但差异无统计学意义(P＞0.05).术后糖皮质激素替代治疗143例(78.14%);甲状腺激素替代治疗89例(48.63%);抗利尿激素替代治疗40例(21.86%).结论 颅咽管瘤患者以儿童及青少年起病多见,临床表现复杂,手术前后均存在内分泌激素水平紊乱,肿瘤本身的占位效应及手术创伤是造成内分泌激素水平低下的根本原因,及早激素替代治疗,定期内分泌激素监控,对改善患者预后、提高患者生活质量具有重要临床意义.
目的 探討鞍區顱嚥管瘤患者的臨床特點,手術前後神經內分泌激素變化規律,為顱嚥管瘤患者內分泌激素鑑控和更好地替代治療、進一步實施教育提供依據.方法 迴顧性分析183例顱嚥管瘤患者臨床錶現、手術前及手術後不同時期內分泌激素變化等的臨床資料.結果 患者術後甲狀腺、腎上腺、性腺激素(泌乳素除外)測定較術前均下降,差異有統計學意義(P＜0.05或＜0.01);術後10 d與術後3 d比較,甲狀腺(除T4外)、腎上腺、性腺激素水平雖有好轉,但差異無統計學意義(P＞0.05).術後糖皮質激素替代治療143例(78.14%);甲狀腺激素替代治療89例(48.63%);抗利尿激素替代治療40例(21.86%).結論 顱嚥管瘤患者以兒童及青少年起病多見,臨床錶現複雜,手術前後均存在內分泌激素水平紊亂,腫瘤本身的佔位效應及手術創傷是造成內分泌激素水平低下的根本原因,及早激素替代治療,定期內分泌激素鑑控,對改善患者預後、提高患者生活質量具有重要臨床意義.
목적 탐토안구로인관류환자적림상특점,수술전후신경내분비격소변화규률,위로인관류환자내분비격소감공화경호지체대치료、진일보실시교육제공의거.방법 회고성분석183례로인관류환자림상표현、수술전급수술후불동시기내분비격소변화등적림상자료.결과 환자술후갑상선、신상선、성선격소(비유소제외)측정교술전균하강,차이유통계학의의(P＜0.05혹＜0.01);술후10 d여술후3 d비교,갑상선(제T4외)、신상선、성선격소수평수유호전,단차이무통계학의의(P＞0.05).술후당피질격소체대치료143례(78.14%);갑상선격소체대치료89례(48.63%);항이뇨격소체대치료40례(21.86%).결론 로인관류환자이인동급청소년기병다견,림상표현복잡,수술전후균존재내분비격소수평문란,종류본신적점위효응급수술창상시조성내분비격소수평저하적근본원인,급조격소체대치료,정기내분비격소감공,대개선환자예후、제고환자생활질량구유중요림상의의.
Objective To explore the clinical characteristics,changes of neuroendocrine hormone before and aftter operation in patients with craniopharyngioma,so as to provide the basis for the replacement therapy after operation and educational practice.Methods The clinical data of 183 patients with craniopharyngioma were retrospectively analyzed. Results (1)Symptoms mainly were headache with nausea,disevesight,the second symptom was polydipsia and polyuria,in child,growth and development retardation was more,and another was hypothalamus syndrome.(2)Functions in endocrine:functions in thyreoid,adrenal and gonad(except PRL),the dysfunctions in neurohypophysis was displayed with completed insipidus and immaturity insipidus,contrasted it anteoperation to that postoperation,it was obvious in statishcs meanings (P＜0.05). Conclusions In patients with craniopharyngioma,children and adolescent is more than the other people,clinical situation is complicated,neuroendocrine hormone is derangement before and after operation,tumor itself to oppress and operation trauma are the basic reasons for the hypofunction of neuroendocrine hormpne,hormones replacement therapy and monitoring should be catch earlier.
