Astaf'eva L I, Kadashev B A, Dedov I I, Kalinin P L, Kutin M A, Shkaburo A N, Fomichev D V, Tenedieva V D, Tropinskaia O F
Zh Vopr Neirokhir Im N N Burdenko. 2011;75(4):3-9; discussion 9.
The authors performed comparative analysis of results of primary surgical and medical treatment of 306 patients with macroprolactinoma. The series included 178 male and 128 female patients. The tumor was endosellar in 48 cases, endosuprasellar in 94, invaded skull base in 164. The paper demonstrates that according to dynamics of visual function, neurological and hypopituitary symptoms, and probability of prolactin level normalization, treatment with cabergoline has significant advantages in comparison to surgery. Only surgical treatment of endosellar prolactinomas can compete with conservative treatment. After these operations no postoperative complications were observed, normalization of prolactin level was present in 67% of cases, and these results did not differ from results of medical treatment (71%). In case of extrasellar grown of macroprolactinoma, especially invading skull base, primary medical therapy is preferred.
作者对306例大泌乳素瘤患者的初次手术治疗和药物治疗结果进行了对比分析。该系列包括178例男性患者和128例女性患者。肿瘤位于鞍内的有48例,鞍上的有94例,侵犯颅底的有164例。本文表明,根据视功能、神经和垂体功能减退症状的动态变化以及泌乳素水平正常化的可能性,与手术相比,卡麦角林治疗具有显著优势。只有鞍内泌乳素瘤的手术治疗可与保守治疗相媲美。这些手术后未观察到术后并发症,67%的病例泌乳素水平恢复正常,这些结果与药物治疗结果(71%)无差异。对于鞍外生长的大泌乳素瘤,尤其是侵犯颅底的情况,首选初次药物治疗。