【摘要】 目的 分析手術(shù)治療垂體瘤患者長期臨床恢復(fù)以及生活質(zhì)量改善情況。 方法 回顧性分析2007年12月-2008年9月手術(shù)治療的103例垂體瘤患者術(shù)前以及術(shù)后長期隨訪資料，使用SF-36量表對術(shù)前、術(shù)后患者生活質(zhì)量進(jìn)行評估，分析手術(shù)治療前后患者癥狀、激素水平恢復(fù)情況以及生活質(zhì)量改善情況，并進(jìn)一步分析腫瘤大小、侵襲程度對術(shù)后生活質(zhì)量的影響。 結(jié)果 術(shù)后頭痛癥狀消失52例，視力改善76例，其他癥狀具有不同程度改善；術(shù)后SF-36生活質(zhì)量評估結(jié)果顯示，患者除精神健康外的7個(gè)維度（生理機(jī)能、生理職能、軀體疼痛、一般健康狀況、精力、社會功能、情感職能）均有明顯改善（P＜0.05），不同腫瘤大小及侵襲程度的患者術(shù)后生活質(zhì)量評分均無統(tǒng)計(jì)學(xué)意義（P＞0.05），垂體功能完全恢復(fù)者生活質(zhì)量評分高于垂體功能低下者（P＜0.05）。 結(jié)論 顯微手術(shù)治療垂體瘤患者可明顯改善患者的一般癥狀、提高患者的生活質(zhì)量，單純腫瘤的大小和侵襲程度對術(shù)后生活質(zhì)量的影響程度較小，術(shù)后垂體功能的恢復(fù)程度明顯影響患者的生活質(zhì)量，垂體瘤術(shù)后患者的激素長期替代治療尚需進(jìn)一步加強(qiáng)。【Abstract】 Objective To analyze the long-term clinical recovery and quality of life (QoL) in patients with pituitary adenoma treated by microneurosurgery. Methods The clinical data of 103 patients undergoing microneurosurgery from December 2007 to September 2008 were retrospectively analyzed, health-related questionnairs (SF-36) were used to assess the QoL. The post-surgery recovery of symptoms, endocrine function, and QoL were compared with those of pre-surgery, then the correlation between tumor size, invasive behavior, and QoL were analyzed. Results Headache disappeared in 52 patients. Visual symptoms improved in 76 patients. Other symptoms were also improved. Seven concepts (physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotioning) were improved after surgery (Plt;0.05). The eight health concepts of SF-36 showed no significant difference between patients with different tumor size and invasive behavior (Pgt;0.05). Differences were considered statistically significant between normal and abnormal pituitary function groups after surgery(Plt;0.05) in all concepts. Conclusion Microneurosurgical treatment can improve the general symptoms and the QoL. The tumor size and invasion have little influence on the QoL after surgery, but the improvement of hormone deficiency has influence on the QoL significantly. More attention should be given to the long-term hormone replacement therapy after the pituitary adenoma surgery.
【摘要】 目的 了解四川省基層醫(yī)療衛(wèi)生機(jī)構(gòu)基本醫(yī)療功能開展情況，以便有針對性地采取措施，提高基層醫(yī)療衛(wèi)生機(jī)構(gòu)的服務(wù)能力。 方法 2008年8月采用自填式問卷調(diào)查的方法，對基層醫(yī)療衛(wèi)生機(jī)構(gòu)開展的基本醫(yī)療功能情況進(jìn)行調(diào)查。 結(jié)果 基層醫(yī)療衛(wèi)生機(jī)構(gòu)提供的三類基本醫(yī)療功能（基本檢查項(xiàng)目、常見病診療、家庭診療及轉(zhuǎn)診）總體情況不甚理想，基本檢查項(xiàng)目開展情況社區(qū)衛(wèi)生服務(wù)中心好于鄉(xiāng)鎮(zhèn)/街道衛(wèi)生院。一級項(xiàng)目中除社區(qū)衛(wèi)生服務(wù)中心轉(zhuǎn)出服務(wù)開展比例達(dá)100%外，大部分醫(yī)療衛(wèi)生機(jī)構(gòu)一級、二級項(xiàng)目開展不全，社區(qū)衛(wèi)生服務(wù)中心與鄉(xiāng)鎮(zhèn)/街道衛(wèi)生院X線檢查開展比例均在50%左右，常見病診療部分一級項(xiàng)目開展機(jī)構(gòu)的比例不到30%。家庭診療及轉(zhuǎn)診二級項(xiàng)目兩類機(jī)構(gòu)開展比例均較低?！〗Y(jié)論 基層醫(yī)療衛(wèi)生機(jī)構(gòu)提供的基本醫(yī)療功能特別是常見病診療項(xiàng)目有待加強(qiáng)?！続bstract】 Objective To understand the situation of basic medical services in primary medical institutions of Sichuan province so as to take related measures to improve the medical services in primary medical institutions. Methods We used self-administered questionnaires to investigate the basic medical services in primary medical institutions in August, 2008. Results The general situation of the three types of basic medical services (basic examination items, common disease diagnosis and treatment, family diagnosis and treatment and referrals) was not very good, but the development of basic examination items in the community health service center was better than that in villages and town hospitals or street service center. Among all kinds of first-grade medical health services, except for that the referral service in community health service center accounted for 100%, most of the first and second-grade medical health services were not fully developed. The proportion of X ray detection in community health service center and villages and town hospitals or street service center was about 50%, and the development of common disease diagnosis and treatment among the first grade medical health services accounted for only 30%. The proportion of family diagnosis and treatment and referrals was low. Conclusion The basic medial services in primary medical institutions should be strengthened, especially for the common disease diagnosis and treatment.