Objective To investigate the improvement of pituitary functions after operation , searching for risk factors of postsurgical hypopituitarism.Methods The clinical data of 138 patients with pituitary adenoma admitted to West China Hospital , Sichuan University from January 2016 to January 2017 were analyzed retrospectively.Results Of 138 patients, there were 70 males and 68 females with mean age of 50.Preoperative hypopituitarism were detected in 43 patients.Among them there were thyroid axis deficits (n＝13, 30.2%, 5 recovered after surgery ), male or female reproductive axis deficits (n＝15, 34.9%, 5 recovered after surgery ), adrenocorticotropic hormone (ACTH)／cortisol axis deficits ( n＝7, 16.3%, 1 recovered after surgery ), growth hormone (GH)／insulin-like growth factor-1 ( IGF-1) axis deficits ( n＝6, 14.0%, 3 recovered after surgery ) and total hypopituitarism ( n＝2, none recovered after surgery ).Postoperative newly endocrine deficit rates were 33.3%for thyroid axis (n＝2), 16.7% for male reproductive axis ( n＝1), 50% for adrenocorticotropic hormone (ACTH)／cortisol axis (n＝3) and zero for total hypopituitarism.Male patients were prone to have hypopituitarism (67%vs 43%, P＝0.008).Elder patients were prone to have hypopituitarism postoperative ( mean age 61.7 vs 47.9 years, P＝0.017).Conclusion The prognosis of hypopituitarism can be improved through operative resection of pituitary adenoma , especially in older patients or long-time suffering patients.%目的 研究垂体腺瘤手术治疗对垂体功能改善情况,寻找术后发生垂体功能低下的影响因素;为临床预后判断及改善手术疗效提供依据.方法 回顾性分析华西医院神经外科2016年1月—2017年1月,行手术治疗的138例垂体腺瘤患者的临床资料;进行垂体功能改善相关因素的分析.结果 本组患者中,女性68例,男性70例,平均年龄50岁;术后平均随访17.6个月.术前垂体功能低下者43例(31.2%),其中全垂体功能低下者2例(1.4%),部分垂体功能低下者41例. 41例部分垂体功能低下患者中,甲状腺轴受损者13例(30.2%),术后恢复5例(38.5%);性腺轴受损15例(34.9%),术后恢复5例(33.3%);肾上腺轴受损7例(16.3%),术后恢复1例(14.3%);生长激素轴受损6例(14.0%),术后恢复3例(50%).术后新发垂体功能低下者6例(4.3%),其中甲状腺轴受损者2例(33.3%),性腺轴受损1例(16.7%)和肾上腺轴受损3例(50%).无新发全垂体功能低下患者.男性患者术后垂体功能低下的发生率高于女性(67%vs 43%, P＝0.008);老年患者术后更易发生垂体功能低下(61.7岁 vs 47.9岁,P＝0.017).结论 手术治疗垂体腺瘤能够改善垂体功能低下的预后,尤其是老年及长期罹患垂体功能低下患者.
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