| 摘要: |
| ［摘要］ 目的 分析38例复发垂体腺瘤诊断和治疗的临床资料，探讨其复发的因素及再治疗的选择问题。方法 对38例复发垂体腺瘤的临床表现、影像学资料、治疗方法选择及治疗结果进行回顾性分析，其中31例再次手术，γ-刀治疗4例，PRL腺瘤药物治疗2例，未治疗PRL腺瘤1例。结果 31例再次手术中全切除21例，次全切除7例，大部分切除3例；药物治疗PRL腺瘤2例中PRL下降至正常，肿瘤缩小；γ-刀治疗4例中3例肿瘤缩小，1例肿瘤大小无变化；未治疗的PRL腺瘤1例，6年复查CT/MRI大小无变化，PRL检测在稍高水平，仍在观察中。结论 手术治疗是复发垂体腺瘤主要的有效治疗方法；药物治疗是复发垂体腺瘤的辅助疗法，它能减小腺瘤的体积使激素水平恢复；放疗可使肿瘤组织坏死、体积缩小、激素水平下降。对再次手术不能全切除者，应对视神经、视交叉周围的肿瘤尽量切除，视神经与肿瘤的距离应>5 mm，以便提高放射治疗效果。 |
| 关键词: 垂体腺瘤 复发 再次治疗 |
| DOI：10.3969/j.issn.1674-3806.2011.02.06 |
| 分类号:R 736.4 |
| 基金项目: |
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| Diagnosis and treatment of recurrent pituitary tumors |
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YE Jin，XU Ke-bei，ZHONG Shu，et al.
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Department of Neurosurgery， the People′s Hospital of Guangxi Zhuang Autonomous Region，Nanning 5300021, China
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| Abstract: |
| ［Abstract］ Objective To study the recurring factors and treatment of recurrent pituitary tumors.Methods Thirty-eight cases of recurrent pituitary tumor were reviewed, including their clinic presentations, imaging data, therapy methods, and results. Of 38 cases, 31 cases received second surgical removal, 4 cases received γ-knife, 2 cases PRL-adenomas received medicine, and one PRL-adenoma received no treatment. Of 14 cases received first trans- sphenoid operations, 11 cases received second trans-sphenoid operations and 3 cases received second trans-pterion operations. Of 11 cases received first sub-frontal operations, 7 cases received second trans-sphenoid operations and 4 cases received second sub-frontal operations.Results Of 31 cases received second surgical removal, 21 cases tumors received total recession, 7 cases subtotal recession, and 3 cases major recession. Of 2 cases PRL-adenomas received medicine, one got normal PRL level and tumor diminution. Of 4 cases received γ-knife, 3 cases tumors diminuted and one got no change.Conclusion Surgical removal is most effective method for recurrent pituitary tumor. Medicine is an aid therapy, which got tumor diminution and normal PRL level. Radiotherapy made tumor necrosis, diminution, and hormone level decreasing. For those could not get total recession by second surgical removal, tumor tissue around optic nerve and chiasm should be resected as far as possible in order to radiotherapy. |
| Key words: Pituitary tumors Recurrence Retreatment |
