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  • 手術(shù)治療垂體瘤的療效分析及生活質(zhì)量評估

    【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個維度(生理機能、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一步加強。【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.

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