急性垂体腺瘤卒中病人行经蝶手术前后的垂体功能

Pituitary function in patients with acute pituitary apoplexy before and after transsphenoidal surgery

目的探讨急性垂体卒中病人在经蝶手术前后的垂体功能变化情况。方法回顾性分析25例急性垂体卒中病人的临床及内分泌资料,其中伴垂体-甲状腺轴受损9例,肾上腺功能低下14例,性腺功能低下11例。13例在入院后3 d内手术,12例在1周内手术。结果伴垂体-甲状腺轴受损者术后恢复5例,肾上腺功能低下者恢复8例,性腺功能低下者恢复7例。结论急性垂体卒中多合并垂体功能低下表现,早期手术有助于恢复正常垂体功能。对于术后仍存在垂体功能低下表现者应给予相应激素替代治疗。

Objective To compare the pituitary functions of patients with acute pituitary apoplexy before and after transsphenoidal surgery.Methods The clinical data and results of endocrine examination in 25 cases of acute pituitary apoplexy treated with transsphenoidal surgery were retrospectively analyzed.Before the operation,9 patients suffered pituitary-thyroid function impairment,14 sustained impaired pituitary-adrenal function,and 11 had impairment of the pituitary-gonadal function.Thirteen patients were operated within 3 days after admission and 12 within 1 week.Results After the operation,5 of the 9 patients with hypothyroidism,8 of the 14 with hypoadrenocorticism,and 7 of the 11 with hypogonadism recovered from the hypopituitarism.Conclusion Hypopituitarism is a major manifestation of acute pituitary apoplexy,and timely surgical decompression may benefit the improvement of pituitary function.Patients with hypopituitarism after surgery require corresponding hormone replacement therapy.