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目的分析伽玛刀和显微外科治疗中小型垂体生长激素腺瘤的结果,探讨中小型垂体生长激素腺瘤治疗策略的选择。方法回顾性分析1997年-2010年山西医科大学附属第二医院神经外科和伽玛刀中心的110例直径<3cm、垂体生长激素腺瘤患者的治疗结果。按治疗方式分成伽玛刀立体定向放射外科组(GRS组,n=54)和显微外科组(MS组,n=52),对比两组的肿瘤生长控制率、内分泌功能紊乱的改善、术后并发症、医疗费用和住院天数等。结果两组均随访12个月。GRS组和MS组的肿瘤生长控制率分别为74.1%和73.2%,二者差异没有统计学意义(P=0.875);GRS组和MS组的内分泌紊乱的改善率分别为87.2%和66.7%,二者差异有统计学意义(P=0.037);MS组的术后并发症不管在类型还是发生频率上均高于GRS组;MS组的治疗费用、住院天数明显高于GRS组。结论伽玛刀立体定向外科不仅能有效控制垂体生长激素腺瘤的生长,而且在内分泌功能紊乱的改善和术后并发症的发生均优于显微手术组,且治疗费用、住院天数均少于显微手术组。
Objective To analyze the results of gamma knife and microsurgical treatment of small and medium sized pituitary growth hormone adenoma and to explore the selection of small and medium pituitary growth hormone adenoma treatment strategy. Methods Retrospective analysis of 1997 - 2010 Department of Neurosurgery and Gamma Knife Center, Second Affiliated Hospital of Shanxi Medical University, 110 cases of patients with diameter <3cm, pituitary growth hormone adenoma treatment results. According to the way of treatment, the patients were divided into two groups: control group (GRS group, n = 54) and microsurgery group (MS group, n = 52) .Tumor growth control rate, improvement of endocrine dysfunction, Complications, medical expenses and days of hospitalization. Results Both groups were followed up for 12 months. The tumor growth control rates in GRS and MS groups were 74.1% and 73.2%, respectively, with no significant difference (P = 0.875). The improvement rates of endocrine disorders in GRS and MS groups were 87.2% and 66.7%, respectively The difference between the two groups was statistically significant (P = 0.037). The postoperative complications in MS group were higher than GRS group both in type and frequency of occurrence. The treatment cost and length of stay in MS group were significantly higher than those in GRS group. Conclusion Gamma knife stereotactic surgery not only can effectively control the growth of pituitary growth hormone adenoma, but also improve the endocrine disorders and postoperative complications are better than the microsurgical group, and the cost of treatment, hospitalization days were less than Microsurgery group.