垂体腺瘤不同治疗方法的疗效对比分析

Comparable study of different therapeutic methods in the treatment of pituitary adenoma

目的 :探讨各种类型垂体腺瘤合理有效的治疗方式。方法 :对采用口服溴隐亭、伽玛刀、经鼻 -蝶入路和经颅入路手术治疗的 12 9例垂体瘤的疗效进行对比分析。结果 :伽玛刀组 2 3 2 %的患者和经鼻 -蝶组 10 0 %的患者治疗后肿瘤完全消失 ,经鼻 -蝶组和经颅手术组肿瘤的次全切除率分别为90 0 %和 94 9% ,术后复发率为 5 1%。结论 :育龄妇女的垂体PRL微、小腺瘤可先试用口服溴隐亭治疗并随访 ;伽玛刀可作为各类垂体微、小腺瘤和部分大型腺瘤首选的治疗手段 ;采用经颅入路显微手术和术后辅助放射外科治疗是提高垂体巨型腺瘤全切除率。

Objective To explore the reasonable and effective therapeutical methods in the treatment of pituitary adenoma.Methods 129 cases of pituitary adenoma treated by different methods was studied retrospectively.Therapeutical effects and its complications were also analyzed.Results The rate of tumor completely disappearance (total removal)in γ-knife group and transsphynoidal group were 23.2% and 10.0% respectively.The rate of tumor subtotal removal were 90.0% and 94.9% respectively in transsphynoidal group and transcranial group.Postoperative recurrence was 5.1%.Conclusion The medication of Bromocriptine may apply to pregnancy respected woman with PRL small or micro-pituitary adenoma and should be follow-up;γ-knife radiosurgery may be the first choice of treating all kinds of small?micro-pituitary adenoma and some part of big adenoma;Transcranial approach with microsurgical technique and radiosurgery can improve the rate of tumor total removal in the treatment of giant pituitary adenoma and decrease the recurrence rate.