本文選題：催乳素腺瘤 + 催乳素　； 參考：《廣西醫(yī)科大學》2017年碩士論文

【摘要】：目的:探討經(jīng)單鼻孔蝶竇入路切除垂體PRL腺瘤的手術治療效果。方法:回顧性分析35例在我院神經(jīng)外科接受經(jīng)單鼻孔蝶竇入路垂體PRL腺瘤切除手術患者的臨床資料。檢測患者術前及術后血PRL水平,并對可能影響手術療效的因素如腫瘤大小、腫瘤切除程度及侵襲性進行統(tǒng)計學分析。結果:男性發(fā)病率要低于女性,男女比率為1:1.19;占位效應引起的最常見的臨床表現(xiàn)為頭痛(34.29%)、視覺障礙(40%);內(nèi)分泌異常導致男性患者主要表現(xiàn)為性功能下降(18.75%),女性主要表現(xiàn)為閉經(jīng)(73.68%)、泌乳(21.05%)、不孕(26.32%);男女患者術前PRL水平存在差異(P=0.047);男性患者與女性患者腫瘤大小存在差異(P=0.009);術前PRL水平影響術后第1天PRL水平(P=0.033);手術腫瘤全切患者比未全切患者治愈率高(P=0.006);腫瘤大小影響手術治療效果(P=0.004);術后第1天的血PRL20ng/ml與PRL20ng/ml,患者復發(fā)率存在差異(P=0.031);侵襲性與非侵襲性PRL腺瘤患者的術后復發(fā)率比較差異有統(tǒng)計學意義(P=0.004)。結論:男性患者就診時PRL水平更高腫瘤更大;術前PRL200ng/ml患者術后治愈率比術前PRL200ng/ml患者要低;手術全切患者術后治愈率比未全切患者要高;催乳素微腺瘤患者比大腺瘤患者術后治愈率要高;術后第1天PRL20ng/ml比PRL20ng/ml患者復發(fā)率要低,術后第1天PRL水平可作為預測復發(fā)的指標之一;侵襲性PRL腺瘤比非侵襲性PRL腺瘤患者復發(fā)率高,侵襲性PRL腺瘤術后需行綜合治療。
[Abstract]:Objective: to evaluate the effect of transsphenoidal resection of pituitary PRL adenoma. Methods: the clinical data of 35 patients undergoing transsphenoidal pituitary PRL adenectomy in our hospital were retrospectively analyzed. The serum PRL levels were measured before and after operation, and the factors that might affect the outcome of the operation were analyzed statistically, such as tumor size, tumor resection degree and invasion. Results: the incidence rate of males was lower than that of females. The most common clinical manifestations caused by the space-occupying effect were headache 34.29 and visual disturbance 400.Endocrine abnormality led to the decrease of sexual function in male patients (18.75), and the main manifestations of women were amenorrhea (73.68), lactation (21.05%), infertility (26.32 2). There were significant differences in preoperative PRL levels (P < 0.047); difference in tumor size between male and female patients (P < 0.009); influence of preoperative PRL level on PRL level on the first day after operation (P < 0.033); the cure rate of total tumor resection patients was higher than that of non-total resection patients (P < 0.006); The recurrence rate of PRL20ng/ml was different from that of PRL 20ng / ml on the first day after operation, and the recurrence rate of invasive and non-invasive PRL adenoma was significantly different from that of non-invasive PRL adenoma. Conclusion: the PRL level of male patients was higher than that of PRL200ng/ml patients, the cure rate of PRL200ng/ml patients before operation was lower than that of PRL200ng/ml patients before operation, the cure rate of patients with total operation was higher than that of patients without total resection. The postoperative cure rate of prolactin microadenoma patients was higher than that of macroadenoma patients, the recurrence rate of PRL20ng/ml was lower than that of PRL20ng/ml patients on the first day after operation, and the level of PRL on the first day after operation could be used as a predictor of recurrence. The recurrence rate of invasive PRL adenoma is higher than that of non-invasive PRL adenoma. The invasive PRL adenoma needs comprehensive treatment after operation.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R736.4

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