垂体瘤患者术后垂体功能减退危险因素分析研究

Analysis of Risk Factors for Postsurgicalhy Hypopituitarism in Pituitary Adenoma Patients

目的探讨垂体瘤患者术后垂体功能减退的危险因素。方法回顾性分析2005—2015年在济宁医学院附属医院行外科手术的439例垂体瘤患者的临床资料,包括性别、年龄、肿瘤直径、肿瘤分型、本次是否复发、侵袭性、垂体卒中、手术方式、肿瘤是否全切、术前垂体功能减退、肿瘤复发等,分析术后垂体功能减退发生的影响因素。结果 439例垂体瘤患者中,微腺瘤17例,大腺瘤356例,巨腺瘤66例。阈值效应分析结果显示,肿瘤直径拐点为22 mm。多因素Logistic回归分析结果显示,肿瘤直径>22 mm[OR=1.23,95%CI(1.15,1.31)]、术前垂体功能减退[OR=3.91,95%CI(1.64,9.09)]是影响术后垂体功能减退的因素(P<0.001)。结论肿瘤直径和术前垂体功能减退是术后垂体功能减退的独立危险因素。

Objective To investigate the risk factors for postsurgical hypopituitarism in patients with pituitary adenomas.Methods We retrospectively reviewed the clinical records of 439 pituitary adenoma patients undergoing surgical treatment in the Affiliated Hospital of Jining Medical University from 2005 to 2015.The review included gender,age,tumor diameter,tumor classification,recurrence or not,tumor invasion,pituitary apoplexy,surgical approaches,total tumor resection or not,presurgical hypopituitarism,and tumor recurrence.The risk factors for postsurgical hypopituitarism were analyzed.Results The 439 pituitary adenoma patients included 17 cases of microadenoma cases,356 of macroadenoma and 66 of giant adenoma.Threshold effect analysis showed that the threshold value of tumor diameter was 22 mm.Multivariate Logistic regression analysis revealed that tumor diameter>22 mm〔OR=1.23,95%CI(1.15,1.31)〕,and development of presurgical hypopituitarism〔OR=3.91,95%CI(1.64,9.09)〕were risk factors for postsurgical hypopituitarism(P<0.001).Conclusion Tumor diameter and presurgical hypopituitarism are independent risk factors for postsurgical hypopituitarism.