老年性无功能垂体腺瘤的诊断和治疗

目的:探讨老年无功能垂体腺瘤的早期诊断与治疗特点。方法:回顾分析４３例经手术及病理证实的６０岁以上老年无功能垂体腺瘤的临床特点及治疗效果。结果:肿瘤全切除和次全切除２９例,３２例随访７~１２７个月,生存良好２８例,肿瘤消失２３例,残瘤静止５例,复发４例。结论:老年垂体瘤主要表现为视力障碍(９１%)和垂体功能低下(７０%);经蝶入路显微手术是安全、有效的治疗手段;对残留或复发病人可辅以放疗,但需注意垂体功能低下的并发症。

Diagnosis and Treatment of Pituitary Adenomas in Elderly Patients

Aim:To discuss the early diagnosis and the treatment of non-functioning pituitary adenomas in elderly patients. Methods: The clinical materials included the clinical main manifestations and treatment outcome of 43 elderly patients with non-functioning pituitary adenomas were analyzed retrospectively.Results: Among the total 43 cases,tumor was totally or subtotally removed in 29 cases.There were 32 cases who get long-term follow-up study(mean 48.8months) ,28 of them were in excellent or good state, tumor disappeared in 23 cases, remained in 5 cases, recurred in 4 cases. Conclusion: Non-functioning pituitary adenomas in elderly patients mostly presented with visual deterioration (91%) and hypopituitarism (70 % ). Transsphenoidal microsurgery is the safe and successful procedure for treatment of non-functioning pituitary adenoma in elderly patients. Radiotherapy can be used in some patients with residual or recurred tumor,but we should pay attention to the severe complication of pituitary insufficiency.