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[垂体瘤手术及综合治疗结果的随访评估]

[Catamnestic evaluation of the results of surgical and combined treatment of pituitary tumors].

作者信息

Konovalov A N, Fedorov S N, Sokolov A F, Faller T O, Alekseeva V S

出版信息

Zh Vopr Neirokhir Im N N Burdenko. 1984 May-Jun(3):3-9.

PMID:6087586
Abstract

The work deals with the study of the results of surgical and combined treatment of 455 patients with adenoma of the hypophysis who were operated on between 1971 and 1977. the catamnestic follow-up periods ranged from 2 to 7 years and more. Microsurgical techniques were used in operations on 146 patients, 309 patients underwent operation by the traditional method. Among 455 patients, 190 were treated by surgery alone, whereas 265 patients received combined treatment (surgical intervention and radiotherapy, mostly in the postoperative period). Study of the results of catamnestic investigation showed that with the use of microsurgical techniques the intervention was more radical and tumors with pronounced extrasellar growth could be removed. The current diagnostic and surgical means as well as combined therapy (surgery combined with radiotherapy) do not solve the problem of the prevention of recurrent tumors of the hypophysis. Recurrences were observed in 22.1% of cases after surgical intervention and in 11.1-15.18% of cases after combined treatment. Combined therapy produces poorer results from the standpoint of correction of the visual and hormonal disorders. The existence, of a considerable number of recurrences makes necessary exact identification of the histobiological and hormonal nature of the whole group of adenomas because the classification accepted today does not meet the essence of the clinical problems encountered in the treatment of these tumors. An exact classification of adenomas of the hypophysis according to their spread is necessary.

摘要

这项工作是对1971年至1977年间接受手术的455例垂体腺瘤患者的手术及综合治疗结果进行研究。随访期为2至7年及更长时间。146例患者手术采用显微外科技术,309例患者采用传统方法手术。455例患者中,190例仅接受手术治疗,265例接受综合治疗(手术干预及放疗,主要在术后)。对随访调查结果的研究表明,采用显微外科技术干预更为彻底,能切除向鞍外明显生长的肿瘤。目前的诊断和手术方法以及综合治疗(手术联合放疗)并未解决垂体肿瘤复发的预防问题。手术干预后22.1%的病例出现复发,综合治疗后11.1 - 15.18%的病例出现复发。从视觉和激素紊乱的纠正角度来看,综合治疗效果较差。大量复发情况的存在使得有必要准确确定整个垂体腺瘤组的组织生物学和激素性质,因为目前采用的分类方法不符合这些肿瘤治疗中所遇到临床问题的本质。根据垂体腺瘤的扩散情况进行准确分类很有必要。

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