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老年人垂体瘤的诊断和治疗
引用本文:鲍伟民,顾宇翔,曹晓运,杨德泰.老年人垂体瘤的诊断和治疗[J].中国神经精神疾病杂志,2001,27(5):355-357.
作者姓名:鲍伟民  顾宇翔  曹晓运  杨德泰
作者单位:上海复旦大学华山医院神经外科,
摘    要:目的分析总结老年人垂体瘤的临床、诊断和治疗特点.方法回顾分析80例老年人垂体瘤的资料.结果平均病程3.6年.视力视野障碍66例(82.5%),内分泌紊乱36例,头痛33例,合并其他疾病56例(70%).CT或MRI发现大腺瘤78例(97.5%).手术采用经蝶或经颅入路,肿瘤全切除和次全切除率70%,视力改善率76%,死亡率1.3%.以经蝶入路手术效果为好.50例平均随访54.5个月,生活自理43例,复发5例.术后放疗者垂体功能低下发生率50%.结论老年人垂体瘤病程长,肿瘤大,临床以视路改变为主.CT、MRI可帮助早期诊断.经蝶显微手术为首选治疗.需注意放疗后垂体功能低下的并发症.

关 键 词:垂体腺瘤  老年病人  显微手术  放疗
修稿时间:2001年2月26日

Diagnosis and treatment of pituitary adenomas in elderly patients.
Bao Weimin,Gu Yuxiang,Cao Xiaoyun,Yang Detai.Diagnosis and treatment of pituitary adenomas in elderly patients.[J].Chinese Journal of Nervous and Mental Diseases,2001,27(5):355-357.
Authors:Bao Weimin  Gu Yuxiang  Cao Xiaoyun  Yang Detai
Institution:Bao Weimin,Gu Yuxiang,Cao Xiaoyun,Yang Detai. Department of neurosurgery,Huashan Hospital,Fu Dan University,12 Wulumuqi Zhong Road,Shanghai. 200040. Tel:021-62489999-6422
Abstract:Objective To study the clinic, the diagnostic and the therapeutic features of pituitary adenomas in elderly pa- tients. Methods Retrospective analysis of 80 elderly patients with pituitary adenomas. Results Average illness duration was 3.6 years. Visual dysfunction existed in 66(82.5%), endocrine abnormality in 36, headachein 30, and other accompanied diseases in 56(70%). CT or MRI confirmed macroadeomas in 78 cases (97.5%). The operations were performed through transsphenoidal or transfrontal approach. The total and subtotal excision rate were 70%, visual improvement rate was 71%, and mortality rate was 1. 3%. The operative resutls through transsphenoidal approach was superior to the transfrontal approach. 50 cases were followed-up for an average of 54.5 months, 43 of them could live by themselves, and 5 suffered from recurrence. The occurrence rate of pitu- itary insufficiency after radiotherapy was 50%. Conclusions For elderly patients with pituitary adenomas, the illness duration was long, the tumors were usually large, and the major presentation were visual changes. It is effective to use CT or MRl for early diagnose. Transsphenoidal microsurgery is the first choice for treatment in elderly patients. Attention to the complication of pituitary insufficiency should be paid to the patients treated with radiotherapy.
Keywords:Pituitary adenomas      Elderly patient  Microsugery Radiotherapy
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