老年垂体腺瘤的临床特征及显微外科治疗
投稿时间:2016-12-08  修订日期:2016-12-26  点此下载全文
引用本文:赵奕,焦蒙,连伟,幸兵,姚勇,冯铭,王任直,吴焕文.老年垂体腺瘤的临床特征及显微外科治疗[J].医学研究杂志,2017,46(8):110-113
DOI: 10.11969/j.issn.1673-548X.2017.08.028
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作者单位E-mail
赵奕 1100730 中国医学科学院/北京协和医学院北京协和医院神经外科  
焦蒙 1100730 中国医学科学院/北京协和医学院北京协和医院神经外科  
连伟 1100730 中国医学科学院/北京协和医学院北京协和医院神经外科 lwpumch@hotmail.com 
幸兵 1100730 中国医学科学院/北京协和医学院北京协和医院神经外科  
姚勇 1100730 中国医学科学院/北京协和医学院北京协和医院神经外科  
冯铭 1100730 中国医学科学院/北京协和医学院北京协和医院神经外科  
王任直 1100730 中国医学科学院/北京协和医学院北京协和医院神经外科  
吴焕文 1100730 中国医学科学院/北京协和医学院北京协和医院病理科  
中文摘要:目的 总结分析老年垂体腺瘤的临床特征、治疗及预后情况。方法 回顾分析2010年1月~2012年12月北京协和医院神经外科收治的年龄≥60岁的经鼻蝶窦入路手术的垂体腺瘤患者131例,对其临床特征、治疗及预后情况加以分析。结果 131例患者中男性61例(46.6%),女性70例(53.4%),患者年龄60~83岁,中位年龄65.38岁。临床表现主要为视力障碍或视野缺损(35.9%)。肿瘤最大径线平均26.04±10.72mm,其中58例侵犯海绵窦。131例患者中生长激素增高的15例(11.5%),IGF-1增高15例(11.5%),血ACTH增高8例(6.1%),血清泌乳素增高30例(22.9%)。所有患者均行经鼻蝶窦入路显微外科垂体腺瘤切除术。患者术前合并症主要为高血压病(45.0%)。术后平均随访时间39.6±10.6个月,随访中有19例(16.8%)肿瘤复发,16例(14.2%)行放疗治疗,2例(1.8%)2次于笔者医院行手术治疗,失访18例(15.9%)。结论 老年垂体腺瘤患者手术效果、围术期病死率、并发症发生率与一般人群无明显差异,只要患者一般情况评估可以耐受手术及麻醉且术前准备完善,高龄并不是垂体腺瘤的手术禁忌证。
中文关键词:老年垂体腺瘤  临床特征  经蝶窦入路显微外科手术  预后
 
Clinical Characteristics and Microsurgery Therapy of Pituitary Adenomas in Elderly Patients
Abstract:Objective To investigate the clinical characteristics and treatment of pituitary adenomas in elderly patients. Methods This article was a retrospective study of 131 pituitary adenomas in elderly patients whose ages are not less than 60 years old, being taken transsphenoidalapproach, that was admitted into Peking Union Medical College Hospital (PUMCH) from January 2010 to December 2012, whose clinical characteristics, therapy and prognosis were studied. Results A total of 61 (46.6%) males and 70 females (53.4%) were included, whose mean age was 65.38 years old. The main clinical manifestation was visual defect (35.9%). The average maximum diameter of the tumors was 26.04±10.72mm, with 58 cases were invasive. As for the increasing of GH, IGF-1, ACTH, and PRL were 11.5%, 11.5%, 6.1%, and 22.9%. All patients were taken transsphenoidal approach surgery. The main complication before the operation was hypertension (45.0%). The average follow-up visit time was 39.6±10.6 months. The tumor recurred in 19 patients, 16 patients were taken radiological therapy, 2 cases (1.8%) were taken another operation in our hospital, and the rate of loss to follow-up was 15.9%. Conclusion There is no significant difference in operation effect, the mortality in perioperative period and complications between the elderly and the general. The operation is permitted only if the patient can tolerate the operation and anesthesia, and the preoperative preparation is sufficient, the advanced age is not the contraindication.
keywords:Pituitary adenomas in elderly  Clinical characteristics  Transsphenoidal approach surgery  Prognosis
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