垂体腺瘤的手术治疗:单中心508例临床总结

Surgical treatment of pituitary adenoma: analysis of 508 cases at a single institution

目的总结垂体腺瘤临床特征、手术策略及术后并发症。方法回顾性分析2010年1月至2012年12月期间南京医科大学第一附属医院收治的508例垂体腺瘤的临床特征,比较经蝶窦入路与开颅手术的治疗效果及相关并发症。结果垂体腺瘤男女发病比为1∶1.32,发病高峰年龄为31～60岁,占70.5%。垂体腺瘤激素类型以泌乳素腺瘤、生长激素腺瘤及无内分泌功能腺瘤居多。93.5%的术式为经蝶窦入路。经蝶窦入路垂体腺瘤手术全切率为85.2%,术后7天症状缓解率88.8%,术后5天激素水平明显好转率87.0%。结论经蝶窦入路手术已取代开颅手术成为垂体腺瘤切除术的首选方法。

Objective To explore the clinical features, surgical treatment strategies and complications of pituitary adenomas. Methods The clinical data of 508 cases of pituitary adenomas from January 2010 to De- cember 2012 were retrospective analyzed for evaluation of surgical treatment through transsphenoid approach and craniotomy operation. Results The incidence ratio of pituitary adenoma in male and female was 1： 1.32. The peak incidence was from 31 to 60 years, accounted for 70.5%. Endocrine non-functioning adenomas, prolactin and growth hormone adenomas were the common types. 93.5% of patients were performied through transsphe- noid approach, with total resection rate 85.2%, symptom relief rate after surgery 88.8%, and improved rate of hormone levels after surgery 87.0%. Conclusions The transsphenoid approach is the most preferred operative approach for pituitary adenomas.