Cheng Lidong, Zhu Hongtao, Wang Jing, Wu Sisi, Zhang Suojun, Wang Junwen, Shu Kai
Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Cancers (Basel). 2023 Jan 4;15(2):340. doi: 10.3390/cancers15020340.
Pituitary hormone deficiency (PHD) is one of the most common symptoms and postoperative complications of craniopharyngiomas (CPs). However, the risk factors for PHD in CPs are little known. The purpose of this study was to analyze the risk factors of pre- and postoperative PHD and to investigate replacement therapy for CP patients.
A retrospective study of 126 patients diagnosed with CP was performed. Univariate analysis was performed using Pearson's chi-squared test or Fisher's exact test, and a multiple logistic binary regression model was used to identify the influencing factors of pre- and postoperative PHD in craniopharyngioma.
Children and patients with hypothalamic involvement were more likely to have preoperative PHD. Patients with suprasellar lesions had a high risk of postoperative PHD, and preoperative PHD was a risk factor for postoperative PHD.
Children have a high incidence of preoperative PHD. Preoperative PHD can serve as an independent risk factor for postoperative PHD. Preoperative panhypopituitarism can serve as an indication of pituitary stalk sacrifice during surgery. The management of replacement therapy for long-term postoperative endocrine hormone deficiency in patients with craniopharyngioma should be enhanced.
垂体激素缺乏（PHD）是颅咽管瘤（CPs）最常见的症状和术后并发症之一。然而，颅咽管瘤中垂体激素缺乏的危险因素鲜为人知。本研究的目的是分析术前和术后垂体激素缺乏的危险因素，并探讨颅咽管瘤患者的替代治疗。
对126例诊断为颅咽管瘤的患者进行回顾性研究。采用Pearson卡方检验或Fisher精确检验进行单因素分析，并使用多元逻辑二元回归模型确定颅咽管瘤术前和术后垂体激素缺乏的影响因素。
儿童及下丘脑受累患者术前垂体激素缺乏的可能性更大。鞍上病变患者术后垂体激素缺乏风险高，术前垂体激素缺乏是术后垂体激素缺乏的危险因素。
儿童术前垂体激素缺乏发生率高。术前垂体激素缺乏可作为术后垂体激素缺乏的独立危险因素。术前全垂体功能减退可作为手术中垂体柄牺牲的指征。应加强颅咽管瘤患者术后长期内分泌激素缺乏替代治疗的管理。
