垂体瘤患者术后垂体功能的变化和激素的替代治疗.docxVIP

垂体瘤患者术后垂体功能的变化和激素的替代治疗 廖环解放军第四五五医院上海 200052 【 】 目的 探讨垂体瘤患者术后垂体功能的变化和激素的替代治疗对 术后激素水平的影响?方法 选取木院收治的7 2例垂体瘤患者为研究对象，均行 经鼻腔蝶窦入路垂体瘤切除术,术后开始给予地塞米松和强的松替代治疗?分别在 术后1天，术后1个月，术后3个月和术后6个月检测患者血清中TSH、FT 3、FT 4、ACTH和PTC各激素指标水平，探讨其变化规律.结果 术后1天检测TSH、FT 3、ACTH和PTC的水平均显著低于术前(P 0?0 5 ),提示垂体功能低下.经激 素替代治疗1个月后,TSH、FT3、ACTH和PTC的水平显著高于术后一天的各激 素水平(PV 0?0 5 ).术后3个月的TSH、FT 3、ACTH和PTC的水平显著高于术 后1个月的各激素指标(PV 0?0 5 ).术后6个月各激素指标水平趋于稳定，与术 后3个月相比，差异无统计学差异(P0?0 5).而FT 4水平在术前和术后均无显 箸性变化(P0? 0 5).结论 垂体瘤患者行经鼻腔蝶窦入路垂体瘤切除术后可 出现激素分泌减少,垂体功能减退，及时给予激素替代治疗，患者3个月垂体功能 恢复良好. 【关键词】 垂体瘤；垂体功能减退；激素替代 Cha ngesofPituitaryFunctio nandHormoneReplacementTherapyafterOperatio nof Hypo physoma【Abstract] ObjectiveToinvestigatethecha ng esofpituitaryfunctioni npatie ntsafteroperatio no fhypo physomaa ndtheeffectofhorm on ereplacementtherG apyonpostoperativehormonelevel. Methods 7 2 patientsofpituitarytumorweretreatedbynasaltra nssphe noidalpituitaryadenomaresect ionwereselectedastheresearchobjectinthehospital. Afteroperation,patientsweregive ndexamethasoneandprednisonereplacementtherapy. ThelevelsofTSH,FT 3 ,FT 4 ,ACTHandPTCweredetectedin 1 day, 1 months, 3 monthsand 6 monthsafteroperation. ThechangesofTSH’FT 3 ,FT ,ACTHandPTCwerediscussed? ResultsThelevelsofTSHzFT 3 ,ACTHandPTCinthepostoperativedayweresign讦icantlylowerthanthoseofbeforeoper ation(P V 0 . 0 5 ),whichindicatedthatthefunctionofpituitarywaslower. After 1 mon thsofhorm on ereplaceme nttherapy’thelevelsofTSH’FT 3 ,ACTHandPTCweresigrdficantlyhigherthanthoseofthepostoperativeday(P 0 ? 0 ). ThelevelsofPTC,FT 3 ^ACTHandTSHin 3 mon thsafteroperati on weresig nifica ntlyhigherthanthoseof 1 mon thsafterop G eration(P 0 . 0 5). After 6 mon ths,thelevelsofthehorm on ete ndedtobestable’Therewerenosig n 讦 ican tdifferencesi nthelevelsofthehormonebetween 6 monthsaftersurgeryand 3 monthsafteroperation(P 0 ? 0 5 ). TherewerenosignificantdifferencesinthelevelsofFT4 beforeandafteroperation(P 0 . 0 5). ConG clusio nsPituitaryade no mapatie ntswithpituitarytumorresectionthroughthetrea