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目的根据垂体泌乳素腺瘤患者不同的就诊目的及肿瘤大小、症状的不同,探讨适合病人个性化规范化的最佳治疗方法。方法684例垂体泌乳素腺瘤患者根据肿瘤大小,结合症状及就诊目的,分别采取手术、药物及放疗方法,并评价不同方法的疗效。结果369例采用手术治疗,全切除率为91%,多数为直径>1.5cm的肿瘤。250例药物治疗(溴隐亭)者中有189例微腺瘤患者,其症状改善率为178/189。65例γ刀治疗者中症状改善者为46例。结论对肿瘤直径>1.5cm,有视力障碍者可首选手术治疗。对有生育要求的,肿瘤直径≤1.0cm者首选药物治疗。对于肿瘤直径<1.5cm,未累及视神经,又不能耐受药物治疗者,γ刀治疗效果肯定。临床上应根据患者的具体情况采取个性化治疗方案。
Objective According to different pituitary prolactinoma patients for treatment purposes and tumor size, different symptoms, to explore the best personalized treatment for patients with standardized methods. Methods 684 cases of pituitary prolactinoma patients according to tumor size, combined with symptoms and treatment purposes, respectively, to take surgery, drugs and radiotherapy methods, and evaluate the efficacy of different methods. Results 369 cases were treated surgically. The total resection rate was 91%. Most of the tumors were> 1.5 cm in diameter. There were 189 patients with microadenoma in 250 cases of drug treatment (bromocriptine), and the improvement rate of symptom was 178 / 189.6 46 cases were treated with γ knife treatment. Conclusion The tumor diameter> 1.5cm, with visual impairment may be the preferred surgical treatment. Of reproductive requirements, the tumor diameter ≤ 1.0cm preferred drug treatment. For tumor diameter <1.5cm, did not affect the optic nerve, and can not tolerate drug treatment, γ knife treatment effect is certain. Clinic should be based on the specific circumstances of patients to take personalized treatment.