| Objective: By analyzing the data of the post operation, like the age, gender, tumor size and different operation types of the patients, studying the influence from them to the occurring rates of postoperative water-natrium imbalance, to accumulate the experience on the treatment, to summarize the status of pituitary tumor in our town, to enhance the treatment level, and to improve the prognosis.Methods: Study the clinical records of 526 patients who have got treatment in our hospital and are diagnosed as pituitary tumor by pathologic analysis from January 1st 2002 to October 31st 2007. First of all, analyze these data through the age, gender, major clinical manifestations, tumor size, pathological type, endocrine functional classification and prognosis of the patients'. On the second, screen these data again based on the standard which is composed by operation type and endocrine functional classification, make a packet classification of these data, and use SPSS software 13.0 to study if there is an independent influence to the incidence rate of water-natrium imbalance from the multiple factors like the age, gender, tumor size, surgical approach, excision extention and endocrine type, etc. Only when the P<0.05 will be counted. Result:1 The clinical records show that: (1) Female pituitary tumor patients are more than male, and the ratio is about 1:0.69. (2) The young and middle-aged people have a high risk of the tumor, the patients' age from 20 to 60 are 86% of all. (3) Visual disorder (65.40%) , headache (40.11%) and visual deficit(36.50%) are the most common initial symptoms in pituitary tumor patients; Endocrine symptom is at the second position: in female patients mainly manifested as amenorrhea (37.94%) and lactating (14.79%) ,and in males mainly manifested as sexual hypofunction. (4) The subfrontal approach ( 51.90% ) , trans-nasal-sphenoidal approach (38.40%) and pterion approach(7.98%) are the most superiority operation types. (5) The tumor are basically macroadenoma ( 57.03%) and huge adenomas (40.12%) on the morphology. (6) The tumor are usually PRL-adenoma, LH-adenoma, multiple secretory functional and nonsecretory functional adenoma, and the nonsecretory functional adenoma (45.66%) is the most common one. (7)The improvement rate of visual acuity and visual field after operation is 22.62%, and the mortality rate is 3.42%, the most common complication is water-natrium imbalance which the incidence is 54.18%.2 The statistic analysis shows that: there is no obvious influence from the age, gender, surgical excision extension patient to the incidence of postoperative water-natrium imbalance. But, the incidence of postoperative water-natrium imbalance by trans-nasal-sphenoidal approaching surgery is lower than by digging skull operation. Logistic regression analysis show that, the tumor size, operative approach, endocrine type are the independent risk factors which the odds ratio(OR) are 2.072,0.497(βis a negative number) and 2.885, with 95% confidence interval 1.435～2.992,0.337～0.733 and 1.313～6.341, respectively. All the P number is lower than 0.01.Conclusion:1 In our town, the female pituitary tumor patients are more than males. The patients' age from 40 to 60 have a high risk of the tumor. The tumors are basically macroadenoma and huge adenomas on the morphology. Visual disorder and visual deficit are the most common initial symptoms in the pituitary tumor patients. The most common complication is water-natrium imbalance.2 The analysis improved that the tumor size, operative approach, endocrine type are the independent risk factors to the incidence of postoperative water-natrium imbalance, while age, gender, excision extention are not. |
