Fahlbusch R, Buchfelder M, Müller O A
J R Soc Med. 1986 May;79(5):262-9. doi: 10.1177/014107688607900504.
A series of 101 patients with Cushing's disease underwent transsphenoidal surgery. Diagnosis was fundamentally based on dynamic testing, mainly on the dosage-dependent suppression of cortisol after dexamethasone. The effect of surgery was monitored by intraoperative ACTH measurements. In 96 out of 101 patients a microadenoma of the pituitary was identified and removed selectively. In 74% of patients there was a clinical and endocrinological remission of Cushing's disease. Four 'operative failures' after selective adenomectomy underwent hypophysectomy in a second operation and each remitted. Thus the overall remission rate was 77%. In general, bilateral adrenalectomy was performed in patients who had failed to remit after selective adenomectomy. Although there is a considerable mortality and morbidity in patients with Cushing's syndrome, complications attributed to surgery were low. Two patients died postoperatively. In general, an improvement of disturbed pituitary function was noted after selective adenomectomy.
101例库欣病患者接受了经蝶窦手术。诊断主要基于动态测试，主要是地塞米松后皮质醇的剂量依赖性抑制。通过术中促肾上腺皮质激素（ACTH）测量来监测手术效果。101例患者中有96例发现垂体微腺瘤并进行了选择性切除。74%的患者库欣病实现了临床和内分泌缓解。4例选择性腺瘤切除术后的“手术失败”患者在第二次手术中接受了垂体切除术，均获缓解。因此，总体缓解率为77%。一般来说，选择性腺瘤切除术后未缓解的患者会接受双侧肾上腺切除术。虽然库欣综合征患者有相当高的死亡率和发病率，但手术相关并发症发生率较低。2例患者术后死亡。一般来说，选择性腺瘤切除术后垂体功能紊乱有所改善。
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