垂体腺瘤患者围术期促肾上腺皮质激素与皮质醇变化的研究

为观察垂体腺瘤患者围术期促肾上腺皮质激素 (ACTH)与皮质醇 (COR)的变化 ,选取 2 8例择期脑瘤切除患者 ,分为非垂体瘤组 (Ⅰ组 ,n =7)、生长激素 (GH)升高垂体瘤组 (Ⅱ组 ,n =9)和泌乳素升高垂体瘤组 (Ⅲ组 ,n =1 2 ) ,采用静吸复合全麻。抽取围术期不同阶段的静脉血标本 ,用放免法检测ACTH及COR。结果显示 ,术毕停麻醉2 0min时的ACTH和COR与入院后基础值相比差异显著 (P <0 .0 5) ,且Ⅱ、Ⅲ组与Ⅰ组间差异显著 (P <0 .0 5)。提示 :垂体腺瘤患者术毕时ACTH及COR水平明显高于术前 ,这不同于其他神经外科患者。

Study on the Change of ACTH and COR in Patients with Pituitary Tumor

This study is to observe the change of ACTH and COR in patients with piturtary tumor. 28 patients for elective craniotomy were anesthesied with Isoflune and Propoful. They were divied into the normal pituitary function group(group 1, n =7),GH increase group(group 2, n =9), and PRL increase group(group 3, n =12). Sample vein blood wss taken during different stages of perioperation and ACTH and COR were tested by RIA. We observed apparent significance in three groups when compared T 4 with T 1 ( P < 0.05 ), and there is apparent difference between group 1 and group 2, and between 1 and group 3 ( P <0.05). So it is concluded that the levels of ACTH and COR at end of operation in patients with pituitary tumor recovered gradully and were higher than that before the operation. This is different from other nerosurgerical patients.