经蝶手术对男性青壮年垂体泌乳素腺瘤患者性腺功能的影响（附70例分析）

目的：探讨经蝶垂体泌乳素腺瘤切除手术对男性青壮年患者性腺功能的影响。方法：回顾性分析复旦大学附属华山医院神经外科2005年10月至2007年11月接受经蝶手术的70例男性青壮年（18-45岁）垂体泌乳素腺瘤（平均年龄36．4岁）患者的年龄和性别分布情况、发病特点、肿瘤分型、治疗与预后等情况。确诊主要依靠血泌乳素与MRI及术后病理检查；随访其术后内分泌指标及MRI以及患者的性功能恢复情况。结果：70例男性患者中垂体大腺瘤者56例，肿瘤具有侵袭性者28／70例（40％）；患者治愈率为55．7％（39／70），未愈为44．3％（31／70）；患者性功能恢复正常者16／70例（22．9％），部分改善者23／70例（32．9％），无改善者31／70例（44．3％）。结论：在男性青壮年垂体泌乳素瘤患者中，大腺瘤所占比例较高，巨大型及侵袭性大腺瘤的比例也较高。男性垂体微腺瘤患者手术后性功能恢复良好，巨大型及侵袭性垂体腺瘤患者手术后性功能恢复不佳。

Effects of Transsphenoidal Approach on the Gonadal Function of Adult Male Prolactinoma Patients (A Report of 70 Cases)

Aim： To investigate the effects of transsphenoidal approach on the gonadal function of adult male prolactinoma patients. Methods： Retrospective review of clinical data and treatment outcome for 70 adult male prolactinoma patients aged from 18-45 year at Huashan Hospital from October 2005 to November 2007. Results： In the consecutive series, the ratio of micro and macro adenoma is 14：56. The ratio of invasive ones is 40% （28/70）. Finally, the patients cured is 55.7%（39/70）, not cured is 44.3%（31/70）. Restore of sexual dysfunction in male is 22.9%（16/70）, partly improved is 32.9%（23/70）, no improved is 44.3%（31/70）. Conclusion： The ratio of macro-adenoma in adult male prolactinoma patients is high, as well as the ratio of the invasive ones. The restore of sexual function in microadenoma has an inspiring result. But in the invasive ones there is a disappointed result.