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目的 分析影响垂体腺瘤预后的因素并探讨治疗方法的选择。方法 对经手术治疗的３０８ 例垂体腺瘤中的１５５ 例进行了２ 年以上的随访和远期疗效评价，分别就肿瘤大小、肿瘤类型、手术方式、肿瘤切除范围以及放射治疗对预后的影响作了分析。结果 垂体微腺瘤和小腺瘤的疗效优于大腺瘤和巨大腺瘤，分泌性腺瘤的疗效优于非分泌性腺瘤，肿瘤全切除的疗效优于次全切除和部分切除，大腺瘤经蝶入路的疗效优于经额入路。结论 肿瘤大小和切除范围是影响预后的主要因素。微、小腺瘤选择经蝶入路最佳，大腺瘤尽量采用经蝶入路，巨大腺瘤则是以鞍上下联合入路为宜。
Objective To analyze the factors affecting the prognosis of pituitary adenomas and explore the choice of treatment methods. Methods 155 cases of 308 cases of pituitary adenomas treated by surgery were followed up for more than 2 years and their long-term therapeutic effects were assessed. The effects of tumor size, tumor type, surgical methods, tumor resection range, and radiotherapy on the prognosis were studied. Analysis. Results The efficacy of pituitary microadenomas and small adenomas is superior to that of large adenomas and giant adenomas. The efficacy of secretory adenomas is superior to that of non-secreting adenomas. The effect of total tumor resection is better than subtotal resection and partial resection. Large adenomas The efficacy of transsphenoidal approach is superior to that of the forehead approach. Conclusions Tumor size and resection range are the main factors that influence the prognosis. Microsurgery and small adenomas are the best choices for transsphenoidal approach. Great adenomas are transsphenoidal approach as much as possible. Giant adenomas are preferably combined with anthroposterior approach.