侵袭性垂体腺瘤的临床特点与诊治方法

《侵袭性垂体腺瘤的临床特点与诊治方法》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。

1、侵袭性乖体腺瘤的临床特点与诊治方法作者：崔钢，郑履平,唐文渊单位：垂庆医科大学附属笫一医院神经外科，重庆400016提要:目的探讨侵袭性垂体腺瘤的临床特点与诊治方法。方法冋顾分析经蝶手术治疗的62例侵袭性垂体腺瘤的临床表现、影像学表现及治疗效果，并结合同期78例非侵袭性垂体腺瘤的临床资料进行对比研究。结杲大腺瘤和巨大腺瘤的侵袭性腺瘤发生率为67•5%,明显高于微腺瘤和小腺瘤的15•9%(P<0•01);功能性腺瘤和非功能性腺瘤中的侵袭性腺瘤发生率无显著性差异(P>0•05);侵袭性腺瘤中垂体腺瘤卒中的发生率为22•6%,明显高于非

2、侵袭性腺瘤的5•l%(P<0•01);侵袭性腺瘤中复发性腺瘤所占比例为16•l%,明显高于非侵袭性腺瘤的3•8%(P≪0•05);侵袭性腺瘤的手术全切率(46•8%)明一就低于非侵袭性腺瘤(88•5%,P<0&bulI;01)o结论侵袭性垂体腺瘤的诊断应结合影像学检查、术中所见和病理学检查來综合判定。术后复发率高，故治疗应采取手术治疗结合放射治疗和药物治疗的综合治疗。关键词:垂体腺瘤;侵袭;诊断;治疗中图法分类号:R73-37;R736.4文献标识码:AClinicalcharacteristics,di

3、agnosisandtreatmentofinvasivepituitaryadenomasHUOGang,ZHENGLu-ping,TANGWen-yuan(DepartmentofNeurosurgery,theirstAffiliatedHospital,ChongqingMedicalUni-versity,Chongqing400016,China)Abstract:ObjectiveToinvestigatetheclinicalcharacteristics,diagnosisandtreatmentofinvasivepituitaryadenoma•Methods

4、Theclinicalpresentations,imagingstudiesandsurgicaloutcomesin62patientswithinvasivepituitaryadenomasand78patientswithnoninvasivepituitaryadenomaswereanalyzedretrospectively•ResultsInvasivepituitaryadenomasweremorecommoninpatientswithmacroadenomasthanthosewithmicroadenomas(P<0•01)•T

5、heoccurrenceofpituitaryapoplexywashigherininvasionpituitaryadenomaspatientsthanthosenon-invasion(P<()•01)•Thcrateoftotaltumorresectionwaslowerandtherateofpostoperativerecurrencewashigherinpatientswithinvasivetumorsthanthosewithnoninvasivetumors(P<0•05,0•01)•Conclusion

6、Thediagnosisofinvasivepituitaryadenomasshouldbemadeaccordingtopreoperativeradiologicalsigns,surgicalfindingsandpostoperativepathologicalexaminations•Tumorresectionisusuallypartial,adjuvanttreatment(radiotherapyormedication)isoftennecessaryininvasivepituitaryadenomapatients•Keywords:pituit

7、aryadenoma;invasion;diagnosis;treatment侵袭性垂体腺瘤向蝶窦、两侧海绵窦、鞍上及鞍旁等周围结构浸润生长,其诊断标准不统一，临床根治困难。本研究回顾分析本科于2002-2005年收治的经蝶手术治疗的62例侵袭性垂体腺瘤和78例非侵袭性垂体腺瘤的临床表现、影像学表现及治疗效果，以探讨侵袭性垂体腺瘤的临床特点和诊治方法。1资料与方法l•l一般资料侵袭性垂体腺瘤占44&