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临床正常犬经蝶窦垂体切除术

Transsphenoidal hypophysectomy in the clinically normal dog.

作者信息

Lantz G C, Ihle S L, Nelson R W, Carlton W W, Feldman E C, Lothrop C D, Bottoms G D

机构信息

Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907.

出版信息

Am J Vet Res. 1988 Jul;49(7):1134-42.

PMID:2844109
Abstract

Pituitary function and short-term clinical effects after transsphenoidal hypophysectomy were investigated in clinically normal dogs. In study I, 8 dogs were given polyionic fluids IV during the first 12 hours after surgery. In study II, 4 dogs were given polyionic fluids IV and glucocorticoid supplementation for 7 days. Pituitary function was assessed by evaluating basal ACTH concentrations and results of a growth hormone stimulation test before and 1 and 12 weeks after hypophysectomy, an ACTH stimulation test, a thyrotropin-releasing hormone-stimulation test, and a modified water deprivation/vasopressin response test before and 1, 4, 8, and 12 weeks after hypophysectomy. Gross and histologic evaluations of the surgery site, thyroid and adrenal glands, and skin were done at 12 weeks after surgery. Four dogs from study I died within 27 hours after hypophysectomy. Postmortem examinations of these dogs revealed liver and lung congestion compatible with circulatory collapse. None of the dogs in study II died. For the surviving dogs in both studies, diabetes insipidus developed immediately after hypophysectomy and resolved within 2 weeks. Hypernatremia also developed immediately after hypophysectomy and resolved by 1 week. Production of ACTH was evident at 1 and 12 weeks after hypophysectomy in all dogs, and results of ACTH stimulation tests after surgery were not notably different from results obtained before surgery. Results of thyrotropin-releasing hormone stimulation and growth hormone-stimulation tests supported the diagnosis of hypothyroidism and hyposomatotropism attributable to hypophysectomy. Histologic examination revealed thyroid atrophy, epidermal and dermal atrophy, and normal adrenal glands in all dogs and remnants of the hypophysis in 2 dogs from study I.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

对临床正常的犬进行经蝶窦垂体切除术后的垂体功能及短期临床效果研究。在研究I中,8只犬在术后前12小时静脉输注电解质溶液。在研究II中,4只犬静脉输注电解质溶液并补充糖皮质激素7天。通过评估垂体切除术前、术后1周和12周的基础促肾上腺皮质激素(ACTH)浓度及生长激素刺激试验结果、ACTH刺激试验、促甲状腺激素释放激素刺激试验以及垂体切除术前、术后1周、4周、8周和12周的改良禁水/血管加压素反应试验来评估垂体功能。术后12周对手术部位、甲状腺、肾上腺和皮肤进行大体和组织学评估。研究I中的4只犬在垂体切除术后27小时内死亡。对这些犬的尸检显示肝脏和肺充血,符合循环衰竭。研究II中的犬均未死亡。对于两项研究中存活的犬,垂体切除术后立即出现尿崩症,并在2周内缓解。垂体切除术后也立即出现高钠血症,并在1周内缓解。所有犬在垂体切除术后1周和12周时ACTH分泌明显,术后ACTH刺激试验结果与术前相比无显著差异。促甲状腺激素释放激素刺激试验和生长激素刺激试验结果支持垂体切除术后甲状腺功能减退和生长激素分泌不足的诊断。组织学检查显示所有犬甲状腺萎缩、表皮和真皮萎缩,肾上腺正常,研究I中的2只犬有垂体残余。(摘要截断于250字)

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