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患垂体泌乳素瘤的不孕病人的处理问题至今仍有争论。为确定药物治疗的效果和安全性,作者们对54例临床诊断为无鞍上蔓延的泌乳素瘤患者进行研究。所有病人均因不孕和月经稀发或闭经就诊。经子宫内膜活检或血清孕酮测定证明为不排卵。血清PRL水平为47-312ng/ml。多层面断层X线片提示微腺瘤,通过视野检查、气脑造影或CT检查排除了鞍上蔓延。除了血PRL水平很高及放射学检查确诊垂体瘤外,30例作了PRL刺激试验,其中28例对灭吐灵反应迟钝,25例对促甲状腺激素释放激素(TRH)反应迟钝(增大均<300%)。临床诊断均为泌乳素微腺瘤,用溴隐亭治疗。确定妊娠后停用溴隐亭。整个孕期定期随访头痛和视觉症状、视野检查及血PRL测定,7例曾作羊水穿刺了解胎儿成熟度及羊水PRL含量。分娩时留脐血
The treatment of infertile patients with pituitary prolactinomas remains controversial. To determine the efficacy and safety of drug treatment, the authors studied 54 patients with prolactinoma clinically diagnosed as having no supranuclear spread. All patients were infertility and oligomenorrhea or amenorrhea treatment. By endometrial biopsy or serum progesterone test proved not ovulation. Serum PRL levels were 47-312 ng / ml. Multidimensional tomographic X-rays suggest microadenomas that have been ruled out by visual field examination, pneumo-angiography or CT. In addition to the high blood PRL levels and the diagnosis of pituitary tumors by radiological examination, 30 patients underwent PRL stimulation test, of which 28 were unresponsive to metoclopramide and 25 were unresponsive to TRH (both increasing <300%). Clinical diagnosis of prolactinoid micro-adenoma, bromocriptine treatment. Determine the withdrawal of bromocriptine after pregnancy. The whole pregnancy regular follow-up of headache and visual symptoms, visual field examination and blood PRL determination, 7 cases had amniocentesis to understand fetal maturity and amniotic fluid PRL content. Umbilical cord blood during childbirth