Kalinin P L, Astaf'eva L I, Kadashev B A, Ismailov D B
Burdenko Neurosurgical Institute named, Moscow, Russia.
Zh Vopr Neirokhir Im N N Burdenko. 2017;81(5):117-124. doi: 10.17116/neiro2017815117-124.
Prolactinomas account for about 40% of all pituitary adenomas. The main treatment for prolactinomas is undoubtedly therapy with dopamine agonists (DAs). However, prolonged conservative treatment (for many years or even throughout life) that is necessary for permanent control of the disease makes some patients refuse pharmacological treatment for various reasons. In addition, not all prolactinomas respond to DAs therapy. Sometimes, the patient is not able to continue treatment because of the severity of side effects. Along with tumor resistance to therapy and patient intolerance of DAs, complications (liquorrhea, hemorrhage in the tumor) may occur during conservative treatment. In these cases, surgery is necessary. The paper analyzes the modern literature on various treatment options for prolactin-secreting pituitary adenomas and defines the indications for surgical treatment.
泌乳素瘤约占所有垂体腺瘤的40%。泌乳素瘤的主要治疗方法无疑是使用多巴胺激动剂（DAs）进行治疗。然而，为永久控制病情而进行的长期保守治疗（数年甚至终生）使一些患者因各种原因拒绝药物治疗。此外，并非所有泌乳素瘤都对DAs治疗有反应。有时，患者因副作用严重而无法继续治疗。除了肿瘤对治疗的抵抗和患者对DAs的不耐受外，保守治疗期间可能会出现并发症（脑脊液漏、肿瘤内出血）。在这些情况下，手术是必要的。本文分析了关于分泌泌乳素垂体腺瘤各种治疗选择的现代文献，并确定了手术治疗的适应症。
