Studys On The Clinical Features And The Assessment Of Pituitary Function Of Pituitary Adenomas With Surgical Treatment

Objective: The purpose of this study was to investigate the clinical features of patients with pituitary adenomas treated by surgery,to evaluate the changes of pituitary function before and after operation,and to analyze the risk factors of postoperative hypopituitarism and recurrence.Methods: This study included 439 cases of pituitary tumor patients who underwent surgical treatment in the Department of Neurosurgery of Affiliated Hospital of Jining Medical College from January 1st,2005 to December 31 th,2015.The patient’s age,name,gender,operative time,surgical procedure,clinical symptoms,signs,imaging findings,pathological diagnosis,preoperative and postoperative pituitary function level and postoperative complications were collected;then combined application of outpatient medical system in our hospital and telephone records to collect the patient’s follow-up visit after operation,including regular follow-up visit after operation or not,postoperative dynamic pituitary function,hormone replacement therapy,tumor recurrence.Study the regular pattern to analyze its influencing factors.Results: Among the 439 cases of pituitary adenomas,including 227(51.71%)cases of non-functional adenomas,212 cases of functional adenomas,of which 100 cases were prolactinoma,67 cases were growth hormone tumors,25 cases were multiple hormone adenomas,18 cases were gonadotropin hormone tumors,14 cases were adrenocorticotropic hormone tumors,and thelast 3 cases were thyroid adenomas.Pituitary adenomas have different clinical features depending on different types,but the main symptoms were headache,decreased visual acuity and tumor compression,followed by symptoms of tumors itself caused by abnormal hormone levels,such as amenorrhea galactorrhea infertility,acromegaly,cushing syndrome.Preoperative pituitary function impaired in 93 cases,24 cases of postoperative improved;33 cases with no hypopituitarism occurred hypopituitarism after surgery;postoperative hypopituitarism occurred in 102 cases,including 52 cases of thyroid axis dysfunction,impaired adrenal function in 58 cases,43 cases of low gonadal function;the standard rate of hormone substitution were 69.56%,58%,85.71%.When the tumor diameter was greater than 22 millimetre,with the increase of diameter,the incidence of postoperative hypopituitarism was increased(OR=1.23,95%CI:1.15~1.31,P<0.0001).Tumor diameter was an independent risk factor for tumor recurrence(OR=1.17,95%CI:1.11~1.24,P<0.0001).Conclusions: The clinical manifestations of various types of pituitary tumors were different,but the main symptoms were tumor oppression,followed by abnormal hormone levels.The 3-6 months after surgery of pituitary function is relatively stable,every 3 months after operation within 1 years need regularly visit,1 years later,at least once a year to visit 1 times,to have a comprehensive evaluation of pituitary function and hormone replacement dose adjustment.The tumor diameter and preoperative hypopituitarism were independent risk factors for postoperative hypopituitarism.The diameter of tumor is an independent riskfactor for postoperative recurrence.