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20例肢端肥大症均经显微手术治疗,其中除3例因肿瘤巨大侵入前颅凹及鞍旁而经额下入路外余均经蝶窦入路。术后无一例死亡。经3月～2年随访,全组症状、体征均明显改善,男性5例性功能恢复。女性3例恢复正常月经。5例术前有视力、视野缺损,术后均明显好转。15例作血清GH术前后对比,术后<10ng/ml者9例,降低50％以上者4例,不下降者2例。在适宜的病例,经蝶窦显微手术应作为首选的手术途径。空腹GH测定和GH葡萄糖抑制试验对无影象学改变的肢端肥大症,具有早期诊断的特异性。
20 cases of acromegaly were microsurgical treatment, in which 3 cases due to huge tumor invasion of the anterior fossa and parasellar and forehead by the amount of extra-transsphenoidal approach. No one died after surgery. After 3 months to 2 years of follow-up, all the symptoms and signs of the group were significantly improved, and 5 cases of male sexual function recovered. Three women returned to normal menstruation. 5 cases of preoperative vision, visual field defects, postoperative were significantly improved. 15 cases of serum GH preoperative and postoperative contrast, postoperative <10ng / ml in 9 cases, more than 50% reduction in 4 cases, no decline in 2 cases. In the appropriate cases, transsphenoidal microsurgery should be the preferred surgical approach. Fasting GH assay and GH glucose suppression test for the absence of imaging changes in acromegaly, with early diagnosis of specificity.