溴隐亭治疗后对垂体催乳素微腺瘤手术的影响

The affection of prior bromocriptine treatment to the pituitary sugery for prolactinsecreting microadenoma

目的: 本文分析垂体催乳激素腺瘤微腺瘤术前溴隐亭(Bm )治疗对手术的疗效与并发症的影响。同期内Bm 组的治愈率较对照组为低, 有显著性差异。术中发现肿瘤硬, 硬膜厚, 解剖结构变异, 影响手术的彻底性。术后尿崩的内分泌低下症状也较多。笔者也认为术前不易过久过多的使用Bm 。对有Bm 治疗史的病例, 术后接受放疗时仍需继续少量服药。

The outcome and the frequency of complications in pituitary surgery for prolaction secreting micro adenoma are affected with prior bromocriptine therapy. In our series, 34 patients were divided into two groups. The 21 bromocriptine treated patients (BM group) and 13 untreated control patients. In the BM group, the tumor fibrosis and stucture abnormalization and dural thickening tended to occur more frequently, which advesely affected a complete tumor removal and resulted in a lower surgical cure rate. The postoperative complications of endocrinological insufficiency, such as diabetes insipidus were more frequently as well. We consider it must avoid to use bromocriptine at a high dose for a long duration preoperatively. In prior bromocriptine therapy cases, it might be necessary postoperatively to continue bromocriptine administration at a minor dose and to correct endocrinological insufficiency.\;