[1]邓友寿.经蝶入路切除垂体腺瘤的疗效及复发影响因素分析[J].中国临床神经外科杂志,2016,(09):533-535.[doi:10.13798/j.issn.1009-153X.2016.09.008]
 DENG You-shou..An analysis of curative effect of transsphenoidal surgery on pituitary adenomas and factors related to relapse in the patients with pituitary adenomas[J].,2016,(09):533-535.[doi:10.13798/j.issn.1009-153X.2016.09.008]
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经蝶入路切除垂体腺瘤的疗效及复发影响因素分析()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2016年09期
页码:
533-535
栏目:
论著
出版日期:
2016-09-25

文章信息/Info

Title:
An analysis of curative effect of transsphenoidal surgery on pituitary adenomas and factors related to relapse in the patients with pituitary adenomas
文章编号:
1009-153X(2016)09-0533-03
作者:
邓友寿
617000 四川攀枝花,攀枝花学院附属医院神经外科
Author(s):
DENG You-shou.
Department of Neurosurgery, Affiliated Hospital, Panzhihua College, Panzhihua 617000, China
关键词:
垂体腺瘤经蝶入路手术疗效复发影响因素
Keywords:
Pituitary adenomas Transsphenoidal surgery Curative effect factors Relapse
分类号:
R 739.41; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2016.09.008
文献标志码:
A
摘要:
目的 探讨经蝶入路手术切除治疗垂体腺瘤的疗效及肿瘤术后复发的影响因素。方法 对2009年1月至2015年1月收治的102例经蝶入路手术切除治疗垂体腺瘤患者的临床资料进行回顾性分析,采用Kaplan-Meier法估计不同特征患者的复发,采用Cox回归模型分析影响患者复发的相关因素。结果 术后,81.3%头痛消失,92.4%视力好转,83.8%泌乳停止,75.0%血糖恢复正常。102例术后随访12~64个月,16例(15.7%)出现复发,复发时间为12~60个月,中位无复发生存时间为36月(95% CI为 29.4~42.6)。多元Cox回归分析显示,侵袭性(HR=1.85,95% CI为1.11~3.11;P<0.05)、肿瘤非全切除(hr ci为1.25~4.49;P<0.05)和术后无辅助放疗(hr ci为1.04~4.07;P<0.05)是术后复发的危险因素。>结论 经蝶入路手术切除垂体腺瘤能明显改善患者的症状,总体疗效较好。侵袭性生长、肿瘤非全切除和术后无辅助放疗为肿瘤术后复发危险因素。
Abstract:
Objective To investigate the curative effect of transsphenoidal surgery on pituitary adenomas and factors influencing relapse in patients with pituitary adenomas. Methods The clinical data of 102 patients with pituitary adenomas treated by transsphenoidal surgery from January, 2009 to January, 2015 were retrospectively analyzed. The relapse-free survival rate of patients with pituitary adenomas treated by transsphenoidal surgery was estimated by Kaplan-Meier and compared by Log-rank test and the factors influencing relapse of the tumors were investigated by Cox proportional hazard regression model. Results After transsphenoidal surgery, the headache disappeared in 81.3% (78/96) patients with preoperative headache, the vision was improved in 92.4% (73/79) patients with preoperative vision descending and the blood glucose returned to normal in 75% (18/34) patients with preoperative high blood glucose. After the surgery, the lactation stopped in 31 patients (83.8%, 31/37) and decreased in 6 patients (16.2%, 6/37) of 37 patients with preoperative lactation. Sixteen patients (15.7%) relapsed into the pituitary adenomas from 12 to 60 months after the surgery. The median relapse-free survival time was 36 months (95%CI: 29.4~42.6). Multivariate Cox regression showed that the risk factors related to the relapse of the tumors included the tumors invasiveness (HR=1.85, 95%CI: 1.11~3.11), incomplete resection of the tumor (HR=2.05, 95%CI: 1.04~4.07) and no postoperative adjuvant radiotherapy (HR=2.37, 95%CI: 1.25~4.49). Conclusions Transsphenoidal surgery for pituitary adenomas can significantly relieve patients’ symptoms and the overall effect is good. The patients with invasive tumors or residual tumors after the surgery, or without postoperative radiotherapy are more likely to undergo relapse.

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更新日期/Last Update: 2016-09-30