2022-2023年苏门答腊北方大学医院垂体腺瘤患者经蝶窦手术的预后:一项前瞻性研究

Muhammad Deni Nasution, Abdurrahman Mouza, Muhammad Ari Irsyad
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引用次数: 0

摘要

腺瘤是常见的垂体肿瘤,占颅内肿瘤的10 - 15%。它们是非转移性的,是良性的,起源于脑垂体。引起腺瘤的确切基因突变尚不完全清楚,但它们涉及肿瘤抑制因子失活因子基因和原癌基因激活因子突变。经蝶窦手术是神经眼科症状患者的首选治疗方法,以减轻视神经束的压力,约80%的患者的视力得到改善。对于出现此类症状或肿瘤侵犯视神经的患者,建议进行手术治疗。经蝶窦手术的风险包括尿崩症、电解质失衡、神经功能缺损和脑脊液鼻漏。材料和方法这是一项前瞻性队列设计的临床试验研究,旨在评估2022-2023年在USU医院接受经蝶窦手术的垂体腺瘤患者的预后。研究共纳入13例患者。通过测量术前和术后Na+、K+和Cl−来评估垂体腺瘤患者经蝶窦手术的预后。结果经蝶窦垂体手术可观察到各种术后并发症,并可预见并发症的发生。结论水电解质失衡是垂体腺瘤经蝶窦手术后最常见的并发症之一。它可导致二次住院,如果不立即得到适当治疗,可能危及生命。术前、术后实验室Na+、K+、Cl−和尿量是垂体腺瘤患者经蝶窦手术监测的重要指标。
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Transsphenoid surgery outcomes in pituitary adenoma patients at Sumatera Utara University Hospital in 2022–2023: A prospective study

Background

Adenomas are common pituitary tumors, accounting for 10–15 % of all intracranial tumors. They are non-metastatic and benign, originating in the pituitary gland. The exact genetic mutations causing adenomas are not fully understood, but they involve tumor suppressor inactivator genes and protooncogene activator mutations. Transsphenoidal surgery is the preferred treatment for patients with neuro-ophthalmological symptoms to relieve pressure on the optic tract, resulting in visual improvement for around 80 % of patients. Surgery is recommended for patients with such symptoms or when the tumor invades the optic nerve. Risks of transsphenoidal surgery include diabetes insipidus, electrolyte imbalances, neurological deficits, and CSF rhinorrhea.

Materials and methods

This is a clinical trial study with a prospective cohort design to evaluate outcomes of pituitary adenoma patients who were undergone transsphenoid surgery at USU Hospital in 2022–2023. Total of 13 patients were included in the study. Preoperative and postoperative Na+, K+, and Cl were measured to assess outcomes of transsphenoid surgery in pituitary adenoma patients.

Result

Various postoperative complications can be seen and be anticipated in transsphenoidal pituitary surgery.

Conclusion

Water and electrolyte imbalance is one of the most common complication found in patient who undergone transsphenoid surgery for pituitary adenoma. It can lead to secondary hospital admission and may be life-threatening if not treated adequately and immediately. Preoperative and postoperative laboratory Na+, K+, Cl and urinary output are important parameters to be monitored in pituitary adenoma patient who undergone transsphenoid surgery.

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236
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15 weeks
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