经蝶切除无功能垂体腺瘤对病人生活质量的影响

Analysis of quality of life and impact factors in patients with non-functioning pituitary adenoma after transsphenoidal surgery

目的对无功能垂体腺瘤病人术前和术后生活质量进行评估,并探讨影响病人生活质量的危险因素。方法2014年1月~2014年12月收治的无功能垂体腺瘤40例,采用SF-36问卷评估病人生活质量,结合术前资料及术后随访,采用t检验及Logistic回归分析探讨影响病人生活质量的危险因素。结果病人手术前后生活质量评分分别为(119±10)vs(99±11),肿瘤的侵袭性与术后生活质量下降无明显关系,肿瘤大小则与之呈负相关(r=-6.928,P<0.05),病人术后垂体功能低下,垂体-性腺轴和垂体-肾上腺轴功能减退与生活质量关系密切,而垂体-甲状腺轴则无明显相关。结论经蝶切除无功能垂体腺瘤病人术后生活质量下降,肿瘤大小是其独立危险因素,术后垂体-性腺轴及垂体-肾上腺轴功能减退对病人生活质量的影响更为明显。

Objective To investigate quality of life of the patients with non-functional pituitary adenomas who underwent transsphenoidal surgery(TSS)and analysis the risk factors related to the quality of life.Methods The clinical date of 40 cases with non-functioning pituitary adenomas who underwent TSS in our department during 2014.Quality of life was assessed by SF-36 questionnaire before and after surgery.Results After TSS,the quality of life of patients with non-functioning pituitary adenomas decreased significantly(119±10)vs(99±11).Logistic regression analysis showed tumor size was the the risk factor related to quality of life.There was no significant difference between the tumor invasion and quality of life.But there was a significant difference between the tumor size and the quality of life.Hypopituitarism in ACTH axis and HPG axis was significantly related to quality of life(r=-6.928,P=0.0197<0.05),but not hypopituitarism in TSH axis.Conclusion The size of pituitary adenomas is an independent risk factor to evaluate the postoperative quality of life.And hypopituitarism in ACTH axis and HPG axis has much more effect on the quality of life in patients with non-functioning adenomas after TSS.