经蝶显微手术治疗男性泌乳素腺瘤及对性功能的影响

Transsphenoidal microsurgical treatment of male prolactinoma and sexual disfuction

目的探讨经蝶窦显微手术对男性泌乳素腺瘤患者的治疗效果和对性功能的影响。方法对23例男性泌乳素腺瘤患者进行了部分回顾性和部分前瞻性研究,其中10例术前接受溴隐亭治疗1～14个月(平均7．3个月),剂量在7．5～15．0mg/d。9例完成国际勃起功能评分(II EF-15)问卷调查。结果术前服用溴隐亭治疗者手术治愈缓解8/10例,单纯手术治疗者治愈缓解4/13例,两者疗效差异有统计学意义(X^2=5．490,P=0．036)。9例基于ⅡEF-15问卷评分,术后较术前性功能改善(配对样本t检验,P＜0．05)。结论经蝶显微手术可改善患者的性功能,术前服用多巴胺激动剂有可能提高手术治愈率。

Objective To explore the features of transsphenoidal microsurgical treatment of male prolactinoma and to evaluate the sexual function before and after transsphenoidal microsurgery. Methods A series of 23 cases male prolactinoma were analysed combined with retrospective and prospective study. 9 casese with sexual disfunction had finished the International Index of Erectile Function with 15-item questionnnaire （ Ⅱ EF-15 ） before and after the surgery. Results 8/10 cases treated with dopaminergic agonist combined with surgery achieved complete remission, while only 4/13 cases achieved complete remission with surgery only（x^2 =5.490,P =0. 036）. Accoding to Ⅱ EF-15 ,sexual function improved after surgery in 9 cases（ pairedsample） t test,P 〈0. 05）. Conclusion Transsphenoidal microsurgical treatment of prolactinoma may improve the male sexual functions, Dopaminergic agonist combined transsphenoidal microsurgery may achieve a better outcome.