| Background and Objectives:Pituitary adenoma is the third most common intracranial tumor,accounting for about 15%.The treatment includes drugs,surgery and other methods.The hypopituitary function before and after treatment and postoperative recurrence require clinical attention and close multidisciplinary follow-up.As a clinician,it is particularly important to be familiar with the clinical features,diagnosis and treatment,and postoperative management of pituitary tumors.This study aims to retrospectively analyze the diagnosis and treatment of patients with pituitary tumors in our hospital for ten years,to further discover problems in the clinical diagnosis and treatment process,and to analyze related risk factors for patients with pituitary adenoma,further strengthen the postoperative management and follow-up of patients.Methods:To retrospectively analyze the information of patients with pituitary adenoma treated in Qilu Hospital of Shandong University in the past ten years,including sex,age,clinical performance,physical examination,hormone level,blood lipids,blood glucose and other laboratory examination and MRI or CT examination,using Nonparametric Tests,Logistic regression and other statistical methods to statistical description,and analyze the anterior pituitary function of patients.Further stratification of gender,age and pathological type is carried out,and the relevant factors of hypofunction of anterior pituitary occur before and after treatment between different ages,different sexes and different tumor types.Randomly selected patients with recent pituitary tumor surgery in our hospital,followed up on the evaluation of anterior pituitary function and postoperative hormone replacement within six months after surgery,and analyzed the status of postoperative comprehensive management of pituitary tumor patients.Patients with pituitary adenomas and non-functioning adenomas who relapsed and did not relapse after surgery were performed between-group Mann-Whitney U test and Chi-square test,and further regression analysis was performed to explore the risk factors of pituitary adenomas and non-functioning adenomas for postoperative recurrenceResults:1.Nearly ten years in our hospital patients with pituitary adenoma after selection and exclusion criteria screening,the total number of finalists was 3384 people,of whom 1635 men,accounting for 48.32 percent,1749 women,accounting for 51.68 percent.There are more women than men.In terms of tumor type,782 people were evaluated by complete imaging,large adenomas account for the highest proportion.2.Grouped by sex,between the two groups for Mann-Whitney U test or Chi-Square test,male patients median age 51 years old,female 49 years old,male than female onset age(P<0.0 1);153 occasional tumors were detected in the body occasionally(89 males,64 females),more men than women(5.44%vs.3.66%,P<0.05)/In terms of tumor type,the incidence of microadenomas was higher in women than in men,and the incidence of large adenomas was higher in men than in women.3.The evaluation of the pre-treatment and postoperative anterior pituitary function of patients with pituitary tumor showed that the evaluation rate of the adrenal axis and thyroid axis was higher than that of the gonad axis and the growth hormone axis.Among patients with hypofunction of anterior pituitary,the adenoid axis was most susceptible to affect.Gender,dyslipidemia,and tumor size are related factors of hypofunction of the anterior pituitary gland.4.Follow-up to some patients after surgery,outpatient follow-up for the adrenal axis and thyroid axis evaluation rate is the highest,the incidence of adenine axis function decline is the highest.5.Recurrent group and non-recurrent group were compared,tumor diameter,lipid metabolism disorder,non-neuroendoscopic surgery therapy for tumor recurrence-related factors;Tumor size,compression symptoms,and non-neuroendoscopic surgery are related risk factors for non-functional adenoma recurrence.Conclusions:1.In the last ten years of treatment of pituitary adenoma patients in our hospital,women,large adenoma accounted for a relatively high proportion,male onset age is higher than female,less than 40 years old and 40-60 years old in the main manifestations of compression symptoms significantly higher than the proportion of people over 60 years of age;2.In patients with pituitary tumors with hypofunction of the anterior pituitary gland,the gonadal axis is most likely to be affected.The evaluation rate of the anterior pituitary gland axis and growth hormone axis is low,and the evaluation method needs to be improved;3.Gender,dyslipidemia,and tumor size are related factors for hypofunction of the anterior pituitary in patients with pituitary adenoma;4.The postoperative follow-up evaluation rate of patients with pituitary adenoma is low,the evaluation process is not perfect,and the replacement rate of hormone therapy is low;5.Tumor size,untreated with neuroendoscopy,lipid metabolism disorders can be used as risk factors for the recurrence of pituitary adenomas.Tumor size,compression symptoms,and non-neuroendoscopic surgery are related risk factors for non-functional adenoma recurrence. |
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