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目的总结经蝶窦垂体生长激素(GH)腺瘤切除术对肢端肥大症合并继发性糖尿病或糖耐量减退病人的疗效。方法回顾性分析77例采用经单鼻孔或口鼻蝶改良入路显微手术切除肿瘤治疗该类病人的临床资料。结果肿瘤全切除加次全切除率85.7%;内分泌治愈加缓解56例(72.7%);血糖达到糖尿病一般控制以上标准者67例(87.0%);术后死亡1例。结论经蝶窦手术切除肿瘤能够纠正肿瘤高GH分泌状态,可在术后1周左右使继发性糖尿病及糖耐量减退得到控制。应注意对病人的心功能进行评估与保护。
Objective To summarize the curative effect of transsphenoidal pituitary growth hormone (GH) adenoma excision on acromegaly with secondary diabetes or impaired glucose tolerance. Methods The clinical data of 77 patients who underwent microsurgical resection of the tumor by single nostril or modified approach of the nose and mouth butterfly were retrospectively analyzed. Results Total tumor resection plus subtotal resection was 85.7%. Endocrine therapy was relieved in 56 cases (72.7%). Blood glucose reached 67 (87.0%) as the standard of diabetes control. One case died of postoperative death. Conclusions Transanal resection of the tumor can correct the high GH secretion in the tumor, which can control secondary diabetes and impaired glucose tolerance about 1 week after operation. Should pay attention to the patient’s heart function assessment and protection.