老年性垂体腺瘤的诊治特点

目的:结合有关文献讨论了老年性垂体腺瘤的临床诊断和手术治疗特点。方法:收治了60岁以上的老年性垂体腺瘤19例,男8例,女11例,占同期垂体腺瘤的3.7％,占同期老年性颅内肿瘤的6.8％。年龄平均为62(60～72)岁。临床表现为视力、视野障碍(16例,占84％)、垂体功能低下(13例,占68％)。入院时合并其它系统疾病16例(占84％)。入院前临床误诊为其它疾病7例(占37％)。 结果:所有病人均行手术治疗,其中经额入路手术11例。经蝶窦入路手术8例;肿瘤全切3例,次全切除10例,大部切除6例。随访12例,时间半年至10年,1例术后9年复发,2例分别于术后1、3年死于高血压脑出血。结论:显微镜下经蝶窦入路切除老年性垂体腺瘤较经额入路效果好,并发症少,是一种较为安全有效的治疗方法。

Clinic specificity of pituitary adenoma in senile patients

The clinic specificity about the diagnosis and surgery of senile pituitary adenoma was discussed with reviewing the literatures. Method: 19 cases of senile pituitary adenoma were admitted in our department from Jan. 1974 to May. 1995, accounted for 3.7% of all pituitary adenomas and 6.8% of all senile intracra-nial tumours in the same period. 8 cases were male and 11 cases were female. The age of patients ranged from 60 to 72 years with an average of 62 years old. Clinical manifestations are mainly sight and/ or visual field defect (84 % ) and hypopituitarism (68%). 16 cases combined with other systemic diseases (84% ). Result: All patients underwent sugical operations, trans-frontal procedure for 11 cases and transsphe-noidal procedure for 8 cases. Total resection were done in 3 cases,subtotal resection in 10 and partial resection in 6. 12 cases were followed up from half a year to 10 years,1 case was recurrent after 9 years of operation. 2 cases died of cerebral hemorrhage after 1 and 3 years of operation respectively. Conclusion: The result of our operative experience suggests that transsphenoidal procedure is more effective and caused less operative complications,and is much better than trans-frontal procedure for treatment of senile pituitary adenoma.