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经蝶窦手术治疗垂体卒中与择期手术治疗垂体腺瘤的内分泌结局比较。

ENDOCRINE OUTCOMES OF TRANSSPHENOIDAL SURGERY FOR PITUITARY APOPLEXY VERSUS ELECTIVE SURGERY FOR PITUITARY ADENOMA.

出版信息

Endocr Pract. 2019 Apr;25(4):353-360. doi: 10.4158/EP-2018-0488. Epub 2019 Jan 18.

Abstract

To determine the rate of hormone replacement therapy (HRT) after transsphenoidal surgery (TSS) for pituitary apoplexy (PA) versus elective resection of a null cell (NC) macroadenoma. A retrospective cohort study was performed. Data was collected on all consecutive patients who underwent TSS from December 31, 2000 to December 31, 2016. Patients were split into two groups: () patients that presented with PA, and () patients that underwent elective TSS for NC macroadenoma. Postoperative pituitary function was determined by examining HRT, hormone lab values, and an evaluation by an endocrinologist for each patient. The odds ratio (OR) was calculated to determine if there was an association between PA and the need for HRT after surgery when compared to elective resection of a NC macroadenoma. The need for HRT was significantly higher following surgery for PA compared to resection of a NC macroadenoma (14.7% versus 2.9%, OR = 5.690; 95% confidence interval (CI) = 1.439 to 22.500; = .013). There is an increased need for hormone replacement therapy after surgery in patients with PA versus patients undergoing elective resection of a NC macroadenoma. Further studies are warranted to strengthen this data and help determine further predictors of the need for HRT. = brain natriuretic peptide; = confidence interval; = desmopressin acetate; = growth hormone; = hormone replacement therapy; = magnetic resonance imaging; = null cell (adenoma); = odds ratio; = pituitary apoplexy; = transsphenoidal surgery.

摘要

目的

比较经蝶窦手术(TSS)治疗垂体卒中(PA)与选择性切除无功能性(NC)大腺瘤后激素替代治疗(HRT)的发生率。方法:本研究为回顾性队列研究。收集了 2000 年 12 月 31 日至 2016 年 12 月 31 日期间所有接受 TSS 的连续患者的数据。患者分为两组:()表现为 PA 的患者,和()接受 NC 大腺瘤择期 TSS 的患者。每位患者术后垂体功能均通过检查 HRT、激素实验室值以及内分泌医生评估来确定。计算比值比(OR)以确定与选择性切除 NC 大腺瘤相比,PA 是否与术后 HRT 的需要相关。结果:与选择性切除 NC 大腺瘤相比,PA 患者术后 HRT 的需求明显更高(14.7%比 2.9%,OR=5.690;95%置信区间(CI)=1.439 至 22.500;=0.013)。与选择性切除 NC 大腺瘤相比,PA 患者术后 HRT 的需求明显更高。与选择性切除 NC 大腺瘤相比,PA 患者术后 HRT 的需求明显更高。进一步的研究需要加强这一数据,并帮助确定进一步预测 HRT 需要的因素。

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