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目的分析肾上腺皮质功能低下的垂体无功能腺瘤的诊断和治疗。方法男性27例,女性15例。年龄38～73岁,平均54．2岁,平均病程4．6年。有乏力倦怠,内分泌检查24h尿游离皮质醇(UFC)低于正常,均行经蝶窦显微外科垂体腺瘤切除术。结果随诊6个月至5年,肿瘤消失33例,7例放疗,4例行开颅手术,12例需要补充激素。结论肾上腺皮质激素减退多发于老年病人、垂体腺瘤卒中和侵袭性垂体腺瘤,术中应保护残留垂体组织,围手术期及时补充激素。
Objective To analyze the diagnosis and treatment of pituitary nonfunctioning adenoma with adrenal insufficiency. Methods There were 27 males and 15 females. The age ranged from 38 to 73 years, with an average age of 54.2 years and an average disease duration of 4.6 years. There is fatigue, endocrine examination 24h urine free cortisol (UFC) is lower than normal, all transsphenoidal microsurgical pituitary adenoma resection. Results After follow-up for 6 months to 5 years, the tumor disappeared in 33 cases, 7 cases received radiotherapy, 4 cases underwent craniotomy, and 12 cases required hormone supplementation. Conclusion Adrenocorticotropic hormone decreases in elderly patients, pituitary adenomas, and invasive pituitary adenomas. Pituitary tissue should be preserved during surgery and hormones should be added in the perioperative period.