经蝶手术或加用垂体放射治疗柯兴氏病的预后

Prognosis of Cushing's Disease Treated by Transsphenoidal Surgery or Surgery with Pituitary Radiation

本文报告15例柯兴氏病患者经蝶手术或加用垂体放射治疗的随诊结果。12例手术后1～12周(加放疗者尚未开始放疗)进行了早期随访,其中7例(58.4%)缓解,4例(33.3%)改善,1例(8.3%)无效。15例单纯手术和10例手术加放疗者手术后1.5～6年进行了远期随访。5例单纯手术者均获缓解,其中4例在术后早期有暂时性垂体-肾上腺功能低下。10例手术加放疗者中,3例缓解,5例改善,2例复发。结果提示:经蝶手术是治疗柯兴氏病的一种较好的方法;对手术治疗不满意者,加用垂体放疗有助于进一步控制病情;术后早期暂时性垂体-肾上腺功能低下是判断远期预后的有效指标。

Follow-up results of 15 patients with Cushing's disease after transsphenoidalsurgery or transsphenoidal surgery in combination with pituitary irradiation werereported.Of 12 patients who were followed up 1-12 weeks after operation and priorto radiotherapy,7 were remitted(58.4%),5 improved(33.3%)and 1 ineffective(8.3%).Of 15 patients who were followed up 1.5-6 years after surgery or surgery in combi-nation with radiotherapy,5 with surgery alone were remitted in which 4 had hadtransient pltuitary-adrenal insufficiency at the early stage(1-12 weeks after theoperation);of 10 patients with operation and radiotherapy,3 were remitted,5 impro-ved and 2 relapsed.The results indicated that transsphenoidal surgery was an effec-tive method for the treatment of Cushing's disease;pituitary irradiation was help-ful in further control in patients where the surgery might fail to provide adequateeffect;transient pituitary-adrenal insufficiency might be a good index for the esti-marion of long-term outcome.