428例垂体瘤患者临床特征分析Analysis of Clinical Features of 428 Patients with Pituitary Tumor
邱爽,时立新,庄惠君
QIU Shuang,SHI Lixin,ZHUANG Huijun
摘要(Abstract)：
目的:分析垂体瘤患者临床特征。方法:统计428例垂体瘤患者的性别、年龄、主要临床症状、影像学诊断、手术方式及并发症,比较术前诊断及术后病理诊断的结果差异。结果:男∶女为1.05∶1,41~50岁发病比例最大(27.80%),其次为31~40岁(23.60%);首发症状头痛、头晕、呕吐比例最大183例(42.76%),其次视物模糊、视力下降126例(29.44%);大腺瘤比例为(85.63%)、巨大腺瘤为(7.61%);肿瘤大小为0.4~7.7 cm;MRI诊断率(56.9%)高于CT(30.4%);经蝶入路垂体瘤切除术患者比率(65.71%)高于行经颅入路垂体瘤切除术患者(34.29%),但并发症比例(37.96%)低于经颅入路垂体瘤切除术(58.4%),P<0.05;手术前后诊断符合率以肾上腺皮质激素(ACTH)瘤最高(90%),其次无功能腺瘤仅33.63%,差异最大为生长激素(GH)瘤,符合率仅6.78%。结论:垂体瘤中PRL瘤最常见,经蝶入路垂体瘤切除术是主要手术方式,ACTH瘤术诊断符合率最高。
Objective: To discuss clinical features of patients with pituitary tumor. Methods: A total of 428 patients with pituitary tumor resection were selected,and collecting information including gender,age,clinical features,imaging test results,surgery mode and complications,comparing differences between pre-surgery diagnosis and post-surgery pathological diagnosis. Results: Male: female was 1. 05 ∶ 1,and with respect to the age,the pituitary tumor occurred mostly in 41 ~ 50 years old( 27. 8%),next to 31 ~ 40 years old( 23. 60%); the proportion of large adenomas and giant adenomas was 85. 63% and 7. 61% respectively; the size of the tumor was 0. 4 ~ 7. 7 cm; MRI diagnostic rate( 56. 9%) was higher than CT( 30. 4%); the ratio of patients accepting pituitary tumor resection made by transphenoidal( 65. 71%) was higher than transcranial( 58. 4%),while the postoperative complication of pituitary tumor resection by transphenoidal approach accounted for 37. 96%,which was significantly lower than the transcranial approach of 58. 04%( P < 0. 05). The highest coincidence rate of diagnosis before and after operation was the ACTH adenomas( 90%),second was no functional adenoma( 33. 63%),the biggest difference was GH tumor,with a rate of only 6. 78%. Conclusion: Prolactinoma is the most common type tumor. Transphenoidal approach is major operation mode,and the highest coincidence rate of diagnosis is ACTH adenomas.
关键词(KeyWords)：
垂体瘤;临床症状;诊断;手术后并发症;手术方式
pituitary tumor;clinical symptom;diagnosis;postoperative complications;operation mode
基金项目(Foundation):
作者(Author):
邱爽,时立新,庄惠君
QIU Shuang,SHI Lixin,ZHUANG Huijun
DOI: 10.19367/j.cnki.1000-2707.2015.11.024
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