内镜下经鼻蝶入路治疗儿童及青春期垂体腺瘤

目的探讨儿童及青春期垂体腺瘤的临床特点和内镜下手术治疗。方法回顾性分析31例20岁以下垂体腺瘤病人的临床资料，其中泌乳素腺瘤14例，促肾上腺皮质激素腺瘤8例，生长激素腺瘤6例，无功能性腺瘤3例。均行内镜下经鼻蝶入路垂体腺瘤切除术。结果肿瘤全切除28例，次全切除3例。手术并发症：暂时性尿崩症4例，脑脊液漏2例，水电解质紊乱4例。随访6个月～5年，治愈26例，缓解3例，复发2例。结论儿童及青春期垂体腺瘤多为功能性腺瘤，无功能腺瘤仅占少数。内镜下经鼻蝶入路手术是治疗儿童和青春期垂体腺瘤安全、有效的方法。

Endoscopic transsphenoidal surgery for pituitary adenomas in children and adolescence

Objective To explore the clinical features and surgical treatment under endoscope for pituitary adenomas in children and adolescence. Methods Clinical data of 31 patients less than 20 years old with pituitary adenomas undergoing endoscopic transsphenoidal surgery were analyzed retrospectively, including 14 prolactinomas, 8 adrenocorticotropic hormone-secreting adenomas, 6 growth hormone-secreting adenomas and 3 non-functional pituitary adenomas. Results Total tumor resection was achieved in 28 patients and subtotal resection in 3. The surgical complications included transient diabetes insipidus in 4 patients, cerebrospinal fluid leakage in 2 and electrolyte disturbance in 4. During a follow-up period of 6 months to 5 years, complete cure was achieved in 26 patients, relief in 3 and recurred in 2. Conclusions The pituitary adenomas in children and adolescence are mainly functional adenomas, while non-functional adenomas account for only a small number. Endoscopic transsphenoidal surgery is a safe and effective therapeutic method for pituitary adenomas in children and adolescence.