大型垂体生长激素腺瘤合并重型糖尿病的临床治疗

目的 探讨垂体生长激素腺瘤并发重型糖尿病的临床治疗方法和效果。方法 收治6例大型垂体生长激素腺瘤合并重型糖尿病病人，首先给予大剂量胰岛素控制血糖，待血糖降至10mmol/L左右时手术行肿瘤次全切除，术后常规放疗，DT：50Gy。结果 本组6例病人术后胰岛素所需剂量即明显下降。其中5例获随访0．6～6年，平均随访时间4．5年，均已恢复正常工作，停用任何降糖药物。血糖尿糖复查正常。结论 对大型生长激素腺瘤合并重型糖尿病的病人，积极手术切除肿瘤并辅以放疗是一种迅速有效的治疗选择。

Clinical Treatment of Growth Hormone-producing Pituitary Macroadenoma Accompanied by Severe Diabetes Mellitus

Objective To study the clinical management of growth hormone-producing pituitary adenoma accompanied by severe diabetes mellitus. Methods Six patients with growth hormone-producing pituitary macroadenomas accompanied by severe diabetes mellitus were treated in our department. The high dose of insulin was firstly used to control hyperglycemia. When the level of glucose was decreased to some 10 mmol/L, the operation was performed. After the operation a dose of 50 Gy conventionally radiotherapy was delivered to all the patients. Results The tumors were subtotally resected in 6 patients. The dose of insulin for controlling hyperglycemia was significantly reduced after resection of the tumor. Five patients were followed up for an average time of 4.5 years. All the patients returned to normal works and the normal level of glucose was kept without any drugs. Conclusion Active surgical treatment followed by adjunctive radiotherapy is a prompt and effective choice for the patients with growth hormone-producing pituitary macroadenoma accompanied by severe diabetes mellitus.