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目的对垂体腺瘤卒中的外科诊断和治疗结果进行分析探讨。方法收集2000年1月至2005年12月我院经手术治疗的47例垂体卒中患者的临床资料,进行回顾性分析。结果无功能性垂体腺瘤最多见,占66.7%。头痛是垂体卒中最常见的临床症状,其次是视觉障碍,再次为眼肌麻痹。47例患者中,经蝶手术39例(83%),开颅手术8例(17%),无手术死亡。全部切除肿瘤者42例(89%),次全切除肿瘤者3例(11%)。术后随访12个月至4年,2例(4.2%)肿瘤复发,3例(6.4%)需要长期激素替代治疗。结论无功能腺瘤在急性垂体卒中最多见,急性垂体卒中最常见的症状为突发头痛。急性垂体卒中的首选检查方法是MRI。经蝶入路手术是治疗垂体卒中安全有效的方法。
Objective To analyze the results of surgical diagnosis and treatment of pituitary adenoma stroke. Methods The clinical data of 47 patients with pituitary apoplexy who underwent surgery in our hospital from January 2000 to December 2005 were retrospectively analyzed. Results The most common non-functional pituitary adenomas, accounting for 66.7%. Headache is the most common clinical symptom of pituitary apoplexy, followed by visual impairment, again for ophthalmoplegia. Of the 47 patients, 39 (83%) had transsphenoidal surgery and 8 had craniotomy (17%), with no surgical death. Totally 42 patients (89%) had complete resection of the tumor and 3 (11%) had subtotal resection of the tumor. After 12 months to 4 years of follow-up, 2 (4.2%) tumors relapsed and 3 (6.4%) required long-term hormone replacement therapy. Conclusions Non-functional adenomas are most common in acute pituitary apoplexy. The most common symptom of acute pituitary apoplexy is sudden headache. The preferred method of examination for acute pituitary apoplexy is MRI. Transsphenoidal surgery is a safe and effective method for the treatment of pituitary apoplexy.