Liu Zehao, Zhang Huan, Liu Sha, Chen Huiling
Department of Endocrinology, Xiangya Hospital, Central South University, Changsha, China.
Department of Endocrinology, The people's Hospital of Qiandongnan Autonomous Prefecture, China.
Arch Med Sci. 2019 Oct 29;16(2):460-465. doi: 10.5114/aoms.2019.89356. eCollection 2020.
The aim of this study was to analyse the incidences of hypopituitarism before and after surgical resection of sellar tumours and to find the factors related to the incidences.
From January 2009 to December 2011, 191 patients in the Department of Neurosurgery in Xiangya Hospital, who underwent the surgical resection of sellar tumours, were included in this retrospective analysis. Pre- and postoperative pituitary function assessments were performed by the detection of hormone levels. Tumour size and location were analysed by magnetic resonance imaging (MRI).
In total 152 (79.6%) patients had anterior pituitary hypofunction preoperatively, and 176 (92.1%) patients had anterior pituitary hypofunction postoperatively. The pre- and postoperative adrenal cortex hypofunction incidences were 83 (43.5%) and 103 (53.9%), respectively. Ninety-three (48.7%) patients had thyroid hypofunction preoperatively, and 101 (52.9%) patients had anterior pituitary hypofunction postoperatively. The pre- and postoperative hypogonadism incidences were 131 (68.6%) and 160 (83.8%), respectively. The postoperative incidences of anterior pituitary hypofunction and hypogonadism in patients with craniopharyngioma or pituitary tumours were both significantly higher than the preoperative incidences. Surgery resection methods and tumour sizes were found to be related to the incidence of postoperative hypogonadism.
To sum up, we found that the postoperative incidences of hypopituitarism were higher than the preoperative incidences. Tumour type, surgery resection methods, and tumour sizes were important contributing factors to the incidence of postoperative hypogonadism.
本研究旨在分析鞍区肿瘤手术切除前后垂体功能减退的发生率,并找出与发生率相关的因素。
2009年1月至2011年12月,湘雅医院神经外科191例行鞍区肿瘤手术切除的患者纳入本回顾性分析。通过检测激素水平进行术前和术后垂体功能评估。通过磁共振成像(MRI)分析肿瘤大小和位置。
总共152例(79.6%)患者术前存在垂体前叶功能减退,176例(92.1%)患者术后存在垂体前叶功能减退。术前和术后肾上腺皮质功能减退的发生率分别为83例(43.5%)和103例(53.9%)。93例(48.7%)患者术前存在甲状腺功能减退,101例(52.9%)患者术后存在垂体前叶功能减退。术前和术后性腺功能减退的发生率分别为131例(68.6%)和160例(83.8%)。颅咽管瘤或垂体瘤患者术后垂体前叶功能减退和性腺功能减退的发生率均显著高于术前。手术切除方法和肿瘤大小与术后性腺功能减退的发生率有关。
综上所述,我们发现垂体功能减退的术后发生率高于术前发生率。肿瘤类型、手术切除方法和肿瘤大小是术后性腺功能减退发生率的重要影响因素。