经蝶窦显微手术治疗男性泌乳素腺瘤的长期随访分析

目的评价经蝶窦显微外科手术治疗男性泌乳素腺瘤的长期疗效。方法回顾性分析了52例经蝶窦显微手术及病理证实的男性泌乳素腺瘤的临床资料和长期随访结果。结果52例患者平均病程7．2年，性功能障碍31例，视力视野障碍25例，头痛6例。肿瘤大于4cm有17例。手术采用经蝶人路，全切除36例，次全切除11例，大部分及部分切除5例。随访3-17年（平均5．6年），视力视野改善20例，性功能改善10例。术后随访复查CT或MRI提示肿瘤消失37例，残留静止8例，复发7例。结论经蝶人路显微手术是首选手术治疗方法；术后PRL水平、肿瘤的大小以及术中肿瘤切除程度是影响长期疗效的重要因素，但术后PRL水平是预测预后的最好因素。

Transsphenoidal microsurgery for male patients with prolactinoma: results of long-term follow-up

Objective To assess the long-term therapeutic effects of transsphenoidal microsurgery for prolactinoma in male. Methods The materials of 52 male patients with prolactinoma undergone transsphenoidal microsurgery from 1986 to 2001 were analyzed and followed up retrospectively. Results It was showed from the data that the average duration of illness was 7.2 years ; and 31 cases were with sexual dysfunction; 25 with visual dysfunction; and 6 with headache, and 17 giant adenomas. Total resection was achieved in 36 cases, subtotal in 11 cases, partial in 5 cases. No surgical mortality. Tumor disappeared in 37 cases; the residuary tumor was stable in 8 cases and with 7 recurrent tumors detected by CT or MRI images after operation. Conclusion Transsphenoidal microsurgery is a safe and effective method for operative treatment of prolactinoma in male. The postoperative PRL level, volume and removal rate of prolactinoma in males are important factors for influencing long-term therapeutic effects, but lower postoperative PRL level are the best predictors of long-term remission.