垂体瘤患者术后垂体功能的变化和激素的替代治疗.docVIP

精品论文 参考文献 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 　　【摘要】　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　选取本院收治的７２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、FT３、FT４、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、FT３、ACTH 和PTC的水平均显著低于术前(P＜０．０５),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(P＜０．０５).术后３个月的TSH、FT３、ACTH 和PTC的水平显著高于术后１个月的各激素指标(P＜０．０５).术后６个月各激素指标水平趋于稳定,与术??３个月相比,差异无统计学差异(P＞０．０５).而FT４水平在术前和术后均无显著性变化(P＞０．０５).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ChangesofPituitaryFunctionandHormoneReplacementTherapyafterOperationofHypophysoma【Abstract】　ObjectiveToinvestigatethechangesofpituitaryfunctioninpatientsafteroperationofhypophysomaandtheeffectofhormonereplacementtherＧapyonpostoperativehormonelevel．Methods７２patientsofpituitarytumorweretreatedbynasaltranssphenoidalpituitaryadenomaresectionwereselectedastheresearchobjectinthehospital．Afteroperation,patientsweregivendexamethasoneandprednisonereplacementtherapy．ThelevelsofTSH,FT３,FT４,ACTHandPTCweredetectedin１day,１months,３monthsand６monthsafteroperation．ThechangesofTSH,FT３,FT４,ACTHandPTCwerediscussed．ResultsThelevelsofTSH,FT３,ACTHandPTCinthepostoperativedayweresignificantlylowerthanthoseofbeforeoperation(P＜０．０５),whichindicatedthatthefunctionofpituitarywaslower．After１monthsofhormonereplacementtherapy,thelevelsofTSH,FT３,ACTHandPTCweresignificantlyhigherthanthoseofthepostoperativeday(P＜０．０５)．ThelevelsofPTC,FT３,ACTHandTSHin３monthsafteroperationweresignificantlyhigherthanthoseof１monthsafteropＧeration(P＜０．０５)．After６months,thelevelsofthehormonetendedtobestable,Therewerenosignificantdifferencesinthelevelsofthehormonebetween６monthsaftersurgeryand３monthsafteroperation(P＞０．０５)．TherewerenosignificantdifferencesinthelevelsofFT４beforeandafteroperation(P＞０．０５)．ConＧclusionsPituitaryadenomapatientswithpituitarytumorresectionthroughthetreatmentofpituitarytumormayappearhormonesecretiondecreasedandpituitaryfuncti【oKneydewcloirndes．】After３monthsofhorm