垂体腺瘤(简称垂体瘤)是颅内最常见的肿瘤之一，由于肿瘤位于颅脑深部及内分泌中枢，对周围产生压迫和对内分泌的影响，常给患者的生长、发育、生育功能及生活劳动能力等造成严重损害。近日，羊城晚报记者在中山大学附属第一医院新开设的垂体瘤专病门诊上了解到，垂体瘤虽属良性肿瘤，但由于人们对该疾病的认识不足，仅依靠一种方法达到完全治愈是比较困难的。所以，由内分泌和神经外科医生，甚至更多相关专科医生评估患者情况，制定个体化的治疗方案显得非常必要。

Pituitary adenomas(Hereinafter referred to as pituitary adenoma)Is one of the most common intracranial tumors,Due to the depths and endocrine tumors located in the cerebral central,On the surrounding oppression and the impact on the endocrine,The growth of often give patients/development/Reproductive functions and cause severe damage living labor ability, etc.In recent days,Yangcheng evening news reporter in the first affiliated hospital of sun yat-sen university opened the pituitary adenoma ZhuanBing learned on clinic,Although the benign tumor of pituitary adenoma,But due to the insufficient understanding of the disease,Only rely on one way to completely cure is more difficult.so,By the endocrine and neurosurgeons,Even more related evaluation the clinical situation of specialized subject doctor,It is definitely necessary to formulate individualized treatment plan.

小小垂体长瘤惹出大麻烦 A little long pituitary adenoma with big trouble

　　“垂体是位于人体脑组织中的一个小小的腺体，大概也就一颗花生米大。”中山大学附属第一医院神经外科主任、垂体瘤诊治中心主任王海军介绍，“不过，可千万别小看它，因为人体的各种生命活动大多离不开垂体的正常工作。垂体能分泌生长激素、促甲状腺激素、促肾上腺皮质激素、促性腺激素、泌乳素等，并且通过分泌这些激素来调控人体的生长发育、新陈代谢等各种生理活动。”

"The pituitary gland is located in a small glands in the human brain tissue,Probably just a peanut."First affiliated hospital of sun yat-sen university, director of neurosurgery/The diagnosis and treatment of pituitary adenoma Wang Haijun, director of the center is introduced,"but,Don't look down on it,Because the body of the normal work of the various life activities are inseparable from the pituitary gland.Pituitary gland to secrete growth hormone/Thyroid stimulating hormone/Adrenocorticotropic hormone/gonadotropin/Prolactin, etc.,And through the secretion of the hormone to regulate the body's growth and development/Metabolism and other physiological activities."

　　由于垂体生长在脑组织的底部中央，周围密布着许多非常重要的血管和神经，如视神经、脑底动脉等，因此一旦长出瘤子，其临床表现也复杂多变。垂体瘤又称垂体腺瘤，它是一种内分泌系统肿瘤，大多属于生长缓慢的良性肿瘤，通常发生于青壮年时期，多在30岁～60岁之间，女性较多见。一旦确诊垂体瘤，对患者的生活质量可产生极大的负面影响。

Since the middle of pituitary growth at the base of the brain tissue,Gathering around a lot of very important blood vessels and nerves,Such as the optic nerve/End of cerebral artery, etc.,So once grow tumors,Its clinical manifestations are complex and changeable.Pituitary adenoma is also called the pituitary adenoma,It is a kind of endocrine tumors,Mostly belongs to benign tumors of slow growth,Usually occurs in young adults,Between 30 ~ 60 years old,More women to see.Once the diagnosis of pituitary adenoma,To the patient's quality of life can produce great negative effects.

　　垂体瘤的临床表现千差万别，患者首诊的科室也会相对分散，最常见的就诊科室为内分泌科、神经外科、妇科、生殖、眼科、皮肤科、骨科、男科等。王海军称，在某些基层和专科医院，由于缺乏垂体瘤综合治疗的中心，患者往往辗转多个科室，长期得不到正确的诊断和治疗，从而贻误了病情，给治疗带来更多的困难。

Pituitary tumor the clinical manifestations vary widely,Patients first department may also be relatively scattered,The most common clinic department of endocrinology/neurosurgery/Department of gynaecology/reproductive/eye/dermatology/The orthopaedic/Male, etc..Wang Haijun said,In some basic and specialized subject hospital,Because of the lack of the center of the comprehensive treatment of pituitary adenoma,Patients often in various departments,Can not get the correct diagnosis and treatment for a long time,So as to delay the disease,Bring more difficulties to treatment.

有这些症状时需及时就医 With these symptoms should be timely medical treatment

　　中山大学附属第一医院内分泌科主任医师廖志红称，大众都知道糖尿病、甲亢是内分泌科最常见的疾病，却很少知道垂体和内分泌有密切相关。正常垂体分泌很多激素，当垂体被瘤压迫时，垂体的某些激素分泌减少，也可出现相应的内分泌激素缺乏的症状，某些激素过多或者另外的激素缺乏，就导致错综复杂的临床症状，身体多个系统出现紊乱，垂体瘤也压迫周围神经出现一些压迫症状，例如出现头痛，或对周围视神经产生压迫，导致失明、眼痛、视野缺损，甚至可出现失明、脑积水、下丘脑功能障碍等。

Sun yat-sen university, director of endocrinology, the first hospital affiliated physicians Liao Zhigong said,All know that diabetes of the masses/Jia kang is the most common diseases of endocrinology,Seldom know the pituitary gland and endocrine are closely related.Normal pituitary secretes many hormones,When the pituitary is tumor oppression,Some of pituitary hormone secretion decreases,Also can appear the corresponding lack of symptoms of endocrine hormone,Certain hormones or other hormone lack too much,Leads to complicated clinical symptoms,Multiple body systems turbulence,Pituitary tumor also oppressed some peripheral nerve compression symptoms,For example, appear have a headache,Or on the surrounding the optic nerve compression,Lead to blindness/Sore eyes/Visual field defects,Can appear even blindness/Water on the brain/The hypothalamus dysfunction, etc.

　　廖志红称，在临床上大致将垂体瘤分为两大类，即有分泌功能性腺瘤和无分泌功能性腺瘤，典型的有分泌功能的腺瘤有以下几种——

Liao Zhigong said,In clinical pituitary tumors can be divided into roughly two categories,The secretion neoplasia and no secretion neoplasia,Typical adenomas with secretion have the following -

　　①生长激素型腺瘤。此种类型的腺瘤若在儿童期出现，则表现为巨人症。在成人，肢端肥大症是垂体生长激素腺瘤最常见的症状，具体表现为面容宽大，下颌突出，手足肥厚粗大，指、趾变粗等。

(1) growth hormone adenoma.If this type of adenoma in childhood,, characterized by gigantism.In the adult,Acromegaly is the most common symptoms of pituitary growth hormone adenomas,Embodied in broad face,Chin highlighted,The brotherhood of hypertrophy is bulky,Refers to the/Toe coarsens, etc..

　　②催乳素型腺瘤。这是最常见的有分泌功能的垂体腺瘤。此型临床上以女性患者为多，发病时多表现为月经不调、闭经、不孕、溢乳等。因此，已婚妇女长期月经不调甚至闭经不育者，除要去妇产科就诊外，到内分泌科和神经外科进行全面的检查也很有必要。

(2) the prolactin type adenoma.This is the most common has the secretion of pituitary adenoma.This type clinically to female patients,Ill show is menstruation to be not moved/amenorrhea/infertility/Spilled milk, etc..so,Married woman menstruation to be not moved for a long time even amenorrhoea sterility,Besides going to the obstetrics and gynecology clinic,To endocrinology and neurosurgery to conduct a comprehensive inspection is necessary.

　　③促皮质激素型腺瘤。这是分泌促肾上腺皮质激素的垂体腺瘤。其临床特点是脂肪大量堆积在面部和胸腹部及臀部，而四肢相对瘦小。该症状是垂体过度分泌促肾上腺皮质激素，导致全身脂肪代谢紊乱和分布异常引起的。

(3) promote the cortical hormone adenoma.This is secrete adrenocorticotropic hormone of pituitary adenoma.Its clinical features is accumulation of fat mass in the face, chest and hips,And limbs are relatively small.The symptom is excessive secrete adrenocorticotropic hormone of pituitary,Results in abnormal distribution of body fat metabolism disorder and cause.

　　此外，还有促甲状腺素细胞腺瘤、促性腺激素细胞腺瘤，这两种肿瘤较少见。另外一大类无分泌功能性腺瘤约占25%。这一大类肿瘤临床上早期没有或只有轻度的内分泌失调的症状，男性表现为性欲减退或阳痿早泄，女性表现为不明显的月经紊乱，等等。专家强调，垂体瘤患者的早期症状往往轻微，容易漏诊，故当出现上述征象时应速去医院进行详细检查。

In addition,And thyrotropic hormone cell adenoma/Gonadotropin cell adenoma,These two kinds of tumor is rare.Another major categories without secretion neoplasia accounted for about 25%.The categories of tumor early no or only mild clinical endocrine disorder symptoms,Male characterized by loss of libido or impotence premature ejaculation,Women's menstrual disorders is not obvious,And so on.Experts stressed that,Pituitary adenoma in patients with early symptoms are often mild,Easy to miss,So when these signs shall go to the hospital to check in detail.

治疗意见 Treatment options

王海军： Wang Haijun:

97%的垂体瘤不需要手术 97% don't need surgery of pituitary adenoma

　　“临床上看到不少垂体瘤病人被错切。”他强调，“建议患者应到正规医院的垂体瘤治疗中心进行诊治，因为多数垂体瘤者可能终生都不需要治疗，需对垂体瘤的诊断和治疗方案的选择要格外慎重，以免给患者造成不必要的损伤，甚至终生残疾。”

"Clinical go up to see a lot of pituitary adenoma patients were cut by mistake."He stressed that,"Suggested that patients should be to normal hospital of pituitary adenoma treatment center for diagnosis and treatment,Because most of pituitary adenoma may lifetime all don't need treatment,To the diagnosis of pituitary adenoma and the choice of treatment should be more cautious,In order to avoid unnecessary damage to the patient,Even permanent disability."

　　垂体瘤可以通过手术、药物和放疗等多种方法治疗。他称，治疗主要根据肿瘤的大小、是否分泌激素以及患者并发症的情况决定个体化的治疗方案。通常无内分泌激素异常的小的微腺瘤不一定要治疗，大约97%的垂体无功能瘤是不需要手术的，若没有相应的垂体激素亢进或低减的情况，临床上可以长期在内分泌科随诊。若在随诊的过程中出现相应的临床症状，肿瘤生长速度加快，压迫了周围的组织(如视野缺损等)，可以考虑经鼻蝶微创手术治疗。对于垂体泌乳素分泌型、生长激素型等功能性肿瘤，均需要接受药物治疗，但并不一定需要手术或放射治疗，80%左右泌乳素型垂体瘤需用药物治疗，相当一部分肢端肥大患者术前或术后有残留，需要用生长抑素类药物治疗。

Pituitary tumors by surgery/Methods such as drugs and radiation treatment.He said,Treatment is according to the size of the tumor/Whether secrete hormones and complications in patients with individualized treatment plan.Usually without the small micro adenoma endocrine hormonal abnormalities may not want treatment,About 97% of all pituitary non-functional adenoma is not require surgery,If there is no corresponding pituitary hormone hyperthyroidism or low cut,Can long-term in clinical endocrinology clinic visits.If in the process of follow-up in the corresponding clinical symptoms,Tumor growth was accelerated,Oppression of the surrounding tissue(Such as vision, etc),Consider the nasal butterfly minimally invasive surgery.Type for pituitary prolactin secretion/Growth hormone and other functional tumor,All need to accept medical treatment,But do not necessarily need to surgery or radiation therapy,About 80% prolactin pituitary adenoma type needed medical treatment,Quite a number of patients with Marie preoperative or postoperative residual,Need treatment with somatostatin drugs.

廖志红： Liao Zhigong:

垂体瘤患者需终身随诊 Pituitary adenoma patients need lifelong follow-up

　　核磁共振(MRI)检查及内分泌激素测定是提高垂体瘤早期诊断的重要手段。她提醒，所有罹患垂体瘤的患者，都应该全面评估，终身随诊。很多病人认为手术后万事大吉了，但是，无论是否手术或放疗，一定要定期长期随访，复查评估垂体激素功能水平，必要时复查鞍区MRI，监控肿瘤的复发及生长情况。垂体瘤专病门诊的开设，正是为患者提供全面的、规范化的长期随诊。余燕红

Nuclear magnetic resonance (NMR)(Magnetic resonance imaging (MRI))Examination and determination of endocrine hormone is important means to improve the early diagnosis of pituitary adenoma.She reminded,All of the patients suffered from pituitary adenoma,Should be comprehensive assessment,Lifetime follow-up.Many patients think that all is well after the operation,but,Regardless of whether surgery or radiotherapy,Be sure to long-term follow-up on a regular basis,Review of the evaluation function of pituitary hormone levels,When necessary to review the Magnetic resonance imaging (MRI) saddle area,Monitoring tumor recurrence and growth conditions.The opening of pituitary adenoma ZhuanBing outpatient service,It is to provide patients with comprehensive/Long-term follow-up of standardization.Yu Yangong