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目的 探讨老年人脑垂体腺瘤的诊断与治疗。方法 分析 8例老年人脑垂体腺瘤临床资料。首诊未确诊的 7例多误诊为老年性疾病。本组经内分泌学检查 ,CT或MR确诊。所有病例均采用单侧鼻前庭切口经蝶窦显微手术切除 ,肿瘤切除后行鞍内脂肪填塞 ,筛骨垂直板 ,修补鞍底。对次全切除者给予全程足量的全脑常规放疗。结果 全切和次全切各 4例。术后并发尿崩和脑脊液鼻漏各 1例。经对症处理痊愈 ;另 6例恢复良好。随访 2～ 3年 ,除 1例视力恢复不明显外 ,所有病人原症状基本消失 ,未见复发。结论 老年人脑垂体腺瘤症状不典型且往往合并有其他老年性疾病 ,极易误诊 ,行CT、MR和内分泌检查有利于诊断。经鼻蝶入路显微手术是治疗老年人脑垂体腺瘤的较佳方法。
Objective To investigate the diagnosis and treatment of pituitary adenoma in the elderly. Methods The clinical data of 8 cases of pituitary adenoma in the elderly were analyzed. The first diagnosis of undiagnosed more than 7 cases misdiagnosed as senile diseases. This group by endocrine examination, CT or MR confirmed. All cases were treated by unilateral nasal vestibular incision microsurgical resection of the sphenoid sinus, the sellar fat padding, ethmoid bone vertical plate, the repair of the sellae. Subtotal resection given full full routine brain radiation. The results of all and subtotal cut in 4 cases. Postoperative complications of diabetes insipidus and cerebrospinal fluid rhinorrhea in 1 case. The symptomatic treatment recovered; the other 6 cases recovered well. Follow-up 2 to 3 years, except for 1 case of visual acuity was not obvious, the original symptoms of all patients disappeared, no recurrence. Conclusion The symptoms of pituitary adenoma in the elderly are not typical and often combined with other senile diseases, which are easily misdiagnosed. CT, MR and endocrine examination are helpful for the diagnosis. Transnasal approach microsurgery is a better method for the treatment of pituitary adenoma in the elderly.