单鼻孔经蝶手术切除泌乳素微腺瘤效果评价

Endonasal transsphenoidal microsurgery of microprolactinoma

目的分析单鼻孔经蝶手术切除泌乳素微腺瘤的效果及影响预后的相关因素。方法结合文献资料回顾性分析2001年8月至2004年1月我们收治的泌乳素微腺瘤患者临床资料并依据术前血泌乳素(PRL)水平将所有患者按PRL≤100μg/L、100μg/L～200μg/L及PRL>200μg/L分为3组研究。结果21例患者术后12例PRL水平恢复正常。3组患者术后PRL恢复正常和闭经患者恢复正常月经周期的比率分别为100%(7/7)、80%(4/5)、11.1%(1/9)和66.7%(2/3)、66.7%(2/3)、14.3%(1/7)。7例月经紊乱患者中6例(85.7%)月经恢复正常,78.6%(11/14例)的患者溢乳消失。术前曾用溴隐亭的患者与未用溴隐亭的患者手术疗效比较差异无显著性。结论单鼻孔经蝶手术是治疗泌乳素微腺瘤的有效手段,术前血PRL水平是影响手术预后的主要因素,术前溴隐亭治疗对手术预后无显著影响。

Objective To study the therapeutic effects of endonasal transsphenoidal mlcrosurgery on microprolactinoma and the prognostic factors. Method Clinical data of 21 patients with microprolactinoma were retrospectivly analyzed from August of 2001 to January of 2004. The patients were divided into three groups according to prolactin level（ PRL ）. Results PRL in 12 of 21 cases was recovered. The ratio of recovered PRL and recovered amenorrheawas100%（7/7）,80%（4/5）,11.1%（1/9） and 66.7%（2/3）,66.7（2/3）,14.3%（1/7） in the three groups. 6 cases of 7 with disturbance of amenorrhea recovered and 78.6% （ 11/14 ） cases with galactorrhea disappeared. The therapeutic effect was not significantly different between patients with and without pre-operative treatment by bromocriptine. Conclusion Endonasal transsphenoidal microsurgery is one of the effective treatments of microprolactinoma. Pre-operative prolactin level is the main factor that may affect the therapeutic effect of surgery. Pre-operative application of bmmocriptine has no influence on prognosis.