儿童及青春期垂体腺瘤的诊断与治疗

Diagnosis and treatment of pituitary adenoma in children and adolescents

目的：探讨儿童及青春期垂体腺瘤的临床特点及治疗方法。方法：回顾性分析我院自1994年1月-2007年12月收治的34例儿童及青春期垂体腺瘤患者临床特点、内分泌学检查、影像学检查、手术入路、术后并发症及随访结果。结果：男14例，女20例；年龄9—18岁，平均16．1岁；ACTH腺瘤10例，PHL腺瘤17例；32例经鼻蝶入路手术，2例开颅手术；肿瘤全切除32例（94％），次全切除2例（6％）；32例随访3月-5年，平均38月，恢复良好29例。结论：经鼻蝶显微手术是儿童及青春期垂体腺瘤主要治疗方法；肿瘤侵犯海绵窦术后有残留可考虑γ刀治疗；长期随访观察非常重要，肿瘤复发可再次手术。

Objective： To investigate the diagnosis and treatment of pituitary adenoma in children and adolescents. Methods ： The clinical materials of 34 children and adolescent patients with pituitary adenoma who were treated in our neurosurgery department between January 1994 and December 2007 were retrospectively analyzed, including their selected surgical approaches, postoperative conditions and follow-up data. Results： The age of 14 boy patients and 20 girl patients ranged from 9 to 18 with an average age of 16. 1. 32 patients were operated by transsphenoidal approach and 2 patients by frontotemporal ap- proach. Total resection was achieved in 32 cases （ 94.1% ） and subtotal resection in 2 cases （ 5.9% ）. There were no serious postoperative complications. 32 patients were followed up with an average follow-up period of 38 months. Among them, 29 pa- tients are leading independent and active lives. Conclusion： Transsphenoidal microsurgery is a major treatment for pituitary adenoma in children and adolescents. A long follow-up period is very important. The patients with recurrences can be reoperated.