Tindall G T, McLanahan C S, Christy J H
J Neurosurg. 1978 Jun;48(6):849-60. doi: 10.3171/jns.1978.48.6.0849.
The results of transsphenoidal microsurgery in treating 37 patients (30 women and seven men) with pituitary tumors associated with hyperprolactinemia are presented. Immediate (10-day) postoperative fasting prolactin levels were normal (less than 25 ng/ml) in 19 of 26 patients whose preoperative prolactin level was less than 200 ng/ml, and in only three of 11 patients in whom preoperative prolactin was greater than 200 ng/ml. Twelve of 13 patients with normal preoperative pituitary-target organ function maintained normal axes postoperatively. Thirteen other patients had preoperative deficiencies in one or more pituitary-target organ axes. Postoperatively, in these latter 13 patients, a pituitary-target organ axis that was deficient preoperatively returned to normal in six cases; there was no change in five, and there was impairment in another axis in four instances. Although gross total tumor removal was believed to be complete in 35 of 37 patients, serial postoperative prolactin determinations in four of these 35 patients indicate tumor regrowth. The authors conclude that transsphenoidal microsurgery is currently the operative procedure of choice for the majority of pituitary tumors associated with hyperprolactinemia.
本文呈现了经蝶窦显微手术治疗37例（30例女性和7例男性）伴有高泌乳素血症的垂体瘤患者的结果。26例术前泌乳素水平低于200 ng/ml的患者中，19例术后即刻（10天）空腹泌乳素水平正常（低于25 ng/ml）；而11例术前泌乳素大于200 ng/ml的患者中，仅3例术后即刻空腹泌乳素水平正常。13例术前垂体-靶器官功能正常的患者中，12例术后维持了正常的轴功能。另外13例患者术前存在一个或多个垂体-靶器官轴功能缺陷。术后，在这13例患者中，6例术前存在缺陷的垂体-靶器官轴恢复正常；5例无变化；4例出现另一轴功能受损。尽管37例患者中有35例被认为肿瘤全切，但这35例患者中的4例术后泌乳素系列测定提示肿瘤复发。作者得出结论，目前经蝶窦显微手术是大多数伴有高泌乳素血症的垂体瘤的首选手术方式。
