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柯兴氏病,垂体存在分泌ACTH的腺瘤。作者报告37例柯兴氏病经切除垂体腺瘤(其中31例是直径小于10毫米的微腺瘤),随访6个月～5年,取得良好临床效果的经验。术前评价:由有经验的外科医师进行经蝶骨手术,需要2小时全身麻痹。虽然许多病例有严重的代谢紊乱,绝大部份可经充分准备而耐受此手术。为确定蝶鞍内腺瘤大小和是否有蝶鞍外扩展,需进行蝶鞍和蝶窦小圆多轨迹体层摄影(hypocycloidal polytomograms)以及间距为2毫米的多轨迹体层气脑造影。
In Cushing’s disease, pituitary adenomas secrete ACTH. The authors reported 37 cases of Cushing’s disease with pituitary adenoma (31 of them were microadenomas less than 10 mm in diameter). The follow-up period was 6 months to 5 years, and good clinical results were obtained. Preoperative evaluation: Transsphenoidal surgery performed by an experienced surgeon requires 2 hours of general paralysis. Although many cases have severe metabolic disorders, most of them can be adequately prepared to withstand this operation. In order to determine the size of the adenoids in the sella and whether there is an expansion of the sella, hypocystic polytomograms of the sella and sphenoid sinusoids, and multi-track air-brain brain angiography with a distance of 2 mm were used.