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1979年7月~1992年3月共施行经蝶显微外科切除垂体GH腺瘤212例,其中200例有术前后GH测定对比,大腺瘤132例,微腺瘤68例。1986年后的138例在手术方法上进行了改进。本组总治愈缓解率为72.5%,其中大腺瘤的治疗缓解率从1986年前的31.4%提高到69.1%;微腺瘤从44.4%提高到80.5%。1例手术中出现心脏意外死亡,死亡率为0.5%。GH水平动态观察结果显示,术后2周内GH水平与以后的GH水平基本一致,故认为术后2周GH水平可作为判断手术疗效的主要指标。本文对影响疗效的诸因素及术后常见并发症的防治进行了讨论。
From July 1979 to March 1992, a total of 212 cases of pituitary GH adenomas were treated with transsphenoidal microsurgery. Among them, 200 cases had preoperative and postoperative GH measurements, 132 macroadenomas, and 68 microadenomas. After 1986, 138 cases were improved in surgical methods. The total remission response rate in this group was 72.5%. The therapeutic remission rate of macroadenomas increased from 31.4% before 1986 to 69.1%; microadenomas increased from 44.4% to 80.5%. . An unexpected cardiac death occurred in 1 patient with a mortality rate of 0.5%. The dynamic observation of GH level showed that the GH level was basically the same as the later GH level within 2 weeks after operation. Therefore, it was considered that the GH level at 2 weeks after operation could be used as the main index to judge the curative effect. This article discusses the factors that affect the efficacy and prevention of common postoperative complications.