垂体泌乳素腺瘤手术前后内分泌检测结果的对比研究

Comparative study of endocrine test results before and after pituitary prolactinomas surgery

目的对比研究垂体泌乳素腺瘤手术前后内分泌检测结果。方法统计分析2012年3月至2014年3月该院收治的48例接受垂体泌乳素腺瘤手术患者的临床资料。结果所有患者手术过程中均不需要输血。单鼻孔入路经蝶显微手术时间1.0-2.5h,平均（1.5±0.3）h;经颅手术时间1.6-3.0h,平均（2.5±0.1）h;手术后1d,1、3、6个月患者的雌二醇（E2）、黄体生成素（LH）、孕酮（P）水平均明显高于手术前（P〈0.05）,血清泌乳素（PRL）水平均明显低于手术前（P〈0.05）;手术后1个月患者的促卵泡素（FSH）水平均明显高于手术前（P〈0.05）,但手术前和手术后1d,3、6个月患者的FSH水平之间的差异均无统计学意义（P〉0.05）。结论在垂体泌乳素腺瘤的治疗中,显微手术切除肿瘤能够有效改善患者的内分泌各项指标,且安全便捷,可以作为临床上主要治疗方法。临床还应该在手术前后对患者的内分泌各项指标进行认真的检测,将其检测值的变化充分利用起来,从而为对患者的治疗取得更好的效果、将患者的复发率降低到最低提供良好的前提条件。

Objective To perform the comparative study on the endocrine test results before and after pituitary prolactinomas surgery.Methods The clinical data in 48 cases of pituitary prolactinomas surgery in our hospital from March 2012 to March 2014 were statistically analyzed.Results All patients did not need blood transfusion during surgery.The transsphenoidal microsurgery time via single nostril approach was 1.0-2.5h,average（1.5±0.3）h;transcranial operative time was 1.6-3.0h,average（2.5±0.1）h;the E2,LH and P levels on postoperative 1d,1,3,6months were significantly higher than those before surgery（P〈0.05）,serum prolactin（PRL）level was significantly lower than that before surgery（P〈0.05）;the follicle-stimulating hormone（FSH）level at postoperative 1month was significantly higher than that before surgery（P〈0.05）,but the FSH levels had no statistical differences between before surgery and on postoperative 1d,3,6months（P〉0.05）.Conclusion In the treatment of pituitary prolactinomas,the microsurgery excision of the tumor can effectively improve the endocrine indexes of patients,is safe and convenient,and can be used as the main treatment method.Clinic should also detect patients′preoperative and postoperative endocrine indicators carefully,then fully use the changes of the detection values,thus obtain better effect for the treatment of the patients and provide good preconditions for reducing the relapse rate of patients to the lowest.