Singer Peter A, Sevilla Linda J
Division of Endocrinology and Metabolism, Keck School of Medicine, University of Southern California, 1355 San Pablo Street, Room 118, Los Angeles, CA 90033, USA.
Neurosurg Clin N Am. 2003 Jan;14(1):123-38. doi: 10.1016/s1042-3680(02)00032-3.
Pituitary tumors are common and are often associated with endocrine abnormalities. Furthermore, pituitary surgery itself may result in additional hormonal changes, including impairment of anterior pituitary hormone secretion and, more commonly, abnormalities of ADH regulation. Endocrine management of patients with pituitary or other sellar lesions involves acute hospital-based and longer term office-based evaluation and treatment. In the immediate postoperative period, careful attention must be directed toward sodium and water balance as well as toward recognition of changes in endocrine function. Postoperative measurement of serum hormone levels also helps to determine if resection of a hypersecreting tumor has been successful. To minimize postoperative morbidity, perioperative endocrine assessment and management of patients undergoing pituitary surgery should consist of a team approach, involving both the neurosurgeon and the endocrinologist.
垂体瘤很常见，且常伴有内分泌异常。此外，垂体手术本身可能导致额外的激素变化，包括垂体前叶激素分泌受损，更常见的是抗利尿激素调节异常。垂体或其他鞍区病变患者的内分泌管理涉及以医院为基础的急性期评估和治疗以及以门诊为基础的长期评估和治疗。在术后即刻，必须密切关注钠和水平衡以及内分泌功能的变化。术后测定血清激素水平也有助于确定分泌过多肿瘤的切除是否成功。为了将术后发病率降至最低，垂体手术患者的围手术期内分泌评估和管理应采用团队协作方式，包括神经外科医生和内分泌科医生。
