The Hormone Replacement Treatment Program After Endoscopic Endo Nasal Transsphenoidal Resection Of Non Functional Pituitary Adenoma

Objective:To explore cortisol levels and hormone replacement therapy after endoscopic endonasal transsphenoidal resection of non functional pituitary adenoma and provide some help for clinical treatment.Methods:A total of 40 patients with non functional pituitary adenoma admitted in the Department of Neurosurgery in the First Affiliated Hospital of Nanchang University from January 2013 to December 2014 were analyzed. The patients were treated with endoscopic endonasal transsphenoidal resection and divided into two groups randomly. The first group was treated with physiological doses of hormone replacement(hydrocortisone, 25 mg qd8, 10 mg qd16, experimental group, n=20), the second group was treated without any hormone replacement(control group, n=20).For both groups, venous blood was collected at 8:00 am. to detect the cortisol levels by radioimmunityassay in the first, third and seventh day post operation. Pituitary function were evaluated and the change of cortisol levels were analyzed so as to compare the ratio of hypopituitarism between two groups. The data were dealt with t-test statistic analysis.Results:Cortisol levels in the first, third and seventh day post operation were within the normal range for both the experimental and control group. However, cortisol levels in the first and third day of the experimental group were higher than the control group with significant differences(p<0.05). And the ratio of hypopituitarism prevalence was0% and 15% respectly in two groups with significant statistical differences.Conclusion:A decrease below normal of cortisol levels in Patients with non functional pituitary adenoma and normal cortisol levels prior to the operation were rarely occurs in seven days after operation. But it is suggested that the physiological doses of hormone replacement therapy could effectively prevent hypopituitarism.