经鼻蝶窦行垂体瘤切除术后的激素变化及激素替代治疗疗效

目的:观察研究经鼻蝶窦行垂体瘤切除术后的激素变化以及应用激素替代治疗的临床治疗效果.方法:选择我院2015年3月~2018年3月收入的拟进行经鼻蝶窦实行垂体瘤切除术的垂体瘤患者100例,观察其术前术后相关激素水平,并在术后对患者进行腺体功能评估,根据需要对患者进行激素替代治疗,观察替代治疗后激素水平以及药物剂量的变化.结果:治疗后患者血清水GH、PRL平逐渐降低;FT4水平在术后次日有显著升高,替代治疗后逐渐降低直至恢复正常水平;TSH、ACTH、COR水平在术后次日显著降低,替代治疗后逐渐升高至正常水平;手术后,氢化可的松剂量随着时间的推移而逐渐降低,手术后3m左旋甲状腺素剂量显著低于手术后1d,手术后6m剂量升高;不良反应发生率为4%.讨论:经鼻蝶窦垂体瘤切除术可有效改善患者激素水平,配合术后长时间的激素替代治疗,可使患者相关激素水平逐渐恢复至正常.

Objective:To observe the hormone changes after transsphenoidal sinusionectomy and the effect of hormone replacement therapy.Methods:A total of 100 patients with pituitary adenoma who were to undergo transsphenoidal surgery were selected to observe the levels of relevant hormones before and after surgery,and the patients were given hormone replacement therapy as needed.Results:After treatment.serum GH and PRL levels in patients gradually decreased.7Ihe level of FT4 increased significantly on the second day after surgery,and gradually decreased after replacement therapy until the normal level returned.TSH,ACTH and COR levels decreased significantly on the second day after surgery,and gradually increased to normal levels after replacement therapy.The incidence of adverse reactions was 4%.Conclusion:Transsphenoidal pituitary adenoma resection can effectively improve the hormone level of patients,combined with long-term hormone replacement therapy,can gradually restore the patient's related hormone levels to normal.