成年垂体泌乳素腺瘤手术和药物治疗的疗效对比研究

A Comparative Study of Surgery and Drug Therapy for Adult Prolactinomas

目的:探讨成年垂体泌乳素腺瘤手术和药物治疗的疗效对比研究情况。方法:近来本研究中心调整了垂体泌乳素腺瘤的手术适应证,对于这些接受了手术治疗和药物治疗的424例患者,进行了回顾性研究,同时门诊溴隐亭治疗500例高泌乳素血症伴有垂体腺瘤的患者,分析两种治疗方法的疗效。结果:手术治疗总体治愈率达到63.2%,其中微腺瘤治愈率达到88.2%,非侵袭性大腺瘤达到30.3%,侵袭性巨大腺瘤为0。总体复发率为18.7%,其中微腺瘤复发率为7.1%。药物治疗总体有效率达到81.5%,其中微腺瘤有效率达到90.3%,大腺瘤达到38.2%,巨腺瘤达到20%。结论:药物治疗的总体疗效比手术要好。药物无效、副作用大、体积较大的垂体泌乳素腺瘤,首选手术治疗;微腺瘤和巨腺瘤首选药物治疗。

Objective： Investigate the therapeutic effect of surgery and drug therapy （dopamine receptor agonist） for prolactinomas. Methods：Recently our center adjusted the surgical indications of prolaetinomas, performed retrospective study to 424 operations for prolactinomas, who accepted surgery. At the same time, 500 patients with hyperprolaetinaemia and prolatinomas,were treated by bromocriptine in the clinic. The efficacy of two treatments were analyzed. Results： Total remission rate for surgery was 63.2%, in which microadenoma 88,2%, non-invasive maeroadenoma 30.3%, and no rermnision for giant adnoma. Total recurrence rate was i 8.7%, in which microadenoma 7.1%. Total remission for drug therapy was 8L5%. in which microadenoma 81.5%, macroadenoma 38.2%, and giant adenoma 20%.Conclusion： Total therapeutic efficacy of drug therapy was better than surgery. Surgery is the first choice for prolatinomas with big size, unresponsiveness or with severe side effect to drug, and. Drug therapy is the first choice for microadenomas and giant adenornas.