侵袭性垂体腺瘤的诊治及其护理

目的 探讨侵袭性垂体腺瘤的临床特点与护理措施.方法 回顾分析62例侵袭性垂体腺瘤的临床表现、影像学表现及治疗效果,并结合同期78例非侵袭性垂体腺瘤的临床资料进行对比研究.结果 大腺瘤和巨大腺瘤的侵袭性腺瘤发生率(63.8%)明显高于微腺瘤和小腺瘤(15.9%),差异有统计学意义(P<0.01);功能性腺瘤和非功能性腺瘤中的侵袭性腺瘤发生率分别为44.8%,43.4%,差异无统计学意义(P>0.05);侵袭性腺瘤中肿瘤卒中的发生率(22.6%)明显高于非侵袭性腺瘤(5.1%);侵袭性腺瘤术后复发率(16.1%)明显高于非侵袭性腺瘤(3.8%);侵袭性腺瘤的手术全切率(46.8%)明显低于非侵袭性腺瘤(88.5%),有统计学意义(P<0.01).结论 侵袭性垂体腺瘤的诊断应结合影像学检查、术中所见和病理学检查来综合判定.手术全切率低,术后复发率高,治疗上应采取手术治疗结合放射治疗和药物治疗的综合治疗.加强对侵袭性垂体腺瘤术后的护理,可有效预防和减轻经蝶侵袭性垂体腺瘤术后并发症.

Diagnosis and treatment of invasive pituitary adenomas and nursing

Objective To investigate the clinical characteristics and nursing measures of invasive pituitary adenomas. Methods The clinical presentations, imaging studies and surgical outcomes of 62 patients with invasive pituitary adenornas were retrospectively analyzed, and contrastively studied with clinical information of 78 patients with noninvasive pituitary adenomas at the corresponding period. Results In invasive pituitary adenomas, the occurrence rate of macroadenoma (63.8%) was higher than that of microadenoma (15.9%). The difference had a statistical meaning (P<0.01). The occurrence rates of invasive pituitary adenomas in functional and non-functional adenomas were 44.8% and 43.4%, respectively. The difference had no statistical meaning (P>0.05). The occurrence rate of pituitary apoplexy in invasive pituitary adenomas patients (22.6%)was higher than that in patents with non-invasion (5.1%). The postoperative reoccurrence rate of invasive pituitary adenomas (16.1%) was obviously higher than that of non-invasion ( 3.8% ). The rate of total tumor resection (46. 8% ) was lower that that of non-invasion ( 88.5% ), the difference had a statistical meaning (P<0.01). Conclusions The diagnosis of invasive pituitary adenomas should be made depending on preoperative imaging examination, surgical findings and postoperative pathological examinations. The rate of total tumor resection is low, and the postoperative reoccurrence rate is high. The adjuvant treatment (radiotherapy or medication) is often necessary in invasive pituitary adenomas patients. Strengthening the postoperative nursing of invasive pituitary adenoma is effective for the prevention and mitigation of postoperative complications of invasive transsphenoidal pituitary adenoma.