ABSTRACT
Objective:To observe the effect of hyperbaric oxygen (HBO) therapy on the pituitary function of patients with subacute traumatic brain injury.Methods:Sixty-six patients with subacute traumatic brain injury and hypopituitarism were randomly divided into a control group ( n=33) and an HBO group ( n=33). Patients in both groups were given conventional treatment including dehydration to reduce intracranial pressure, anti-infection medication, epilepsy and bed sores prevention measures, neurotrophic treatment, fluid replacement and rehabilitation. The HBO group was additionally given HBO at 0.2MPa (2.0ATA), once a day, 6 times a week for a total of 20 administrations. Before and after the treatment, serum adrenocorticotropic hormone (ACTH), growth hormone (GH), thyroid stimulating hormone (TSH), prolactin (PRL), luteinizing hormone (LH), follicle stimulating hormone (FSH), cortisol, insulin-like growth factor 1, free tetraiodothyronine, testosterone, and estradiol levels were detected using chemical immunoluminescence. The ACTH, GH, TSH, PRL, LH and FSH values were used to calculate general pituitary hormone scores. Results:After the treatment, the average PRL, LH and testosterone levels and the general pituitary hormone score in the HBO group were significantly higher than among the controls.Conclusions:HBO treatment can increase the levels of various hormones in patients with subacute traumatic brain injury and promote the recovery of pituitary function.
ABSTRACT
Objective To investigate the related influence factors of the main extended direction of the pituitary macroadenoma in the vertical direction.Methods Clinical data of 184 pituitary macroadenoma patients were collected and analyzed retrospectively.The main extended direction in the vertical direction of the tumor was taken as the dependent variables.Patients were divided into two groups according to the suprasellar extension value of each tumor,(ie:suprasellar extension value＞0 and suprasellar extension value≤0).10 selected indicators (age,sex,tumor type,diameter of diaphragmatic opening,sphenoid sinus type,sella type morphology,main sphenoid sinus septum bias,maximum width of sphenoid sinus septum,tumor cyst,number of longitudinal sphenoid sinus septum) were taken as independent variables and the factors which may influence the main extended direction were analyzed and selected by logistic regression method.Results Among the 184 patients,there were 121 cases extending mainly to the suprasellar direction,while the left cases extending mainly to the opposite direction.Statistical analysis showed the tumor type (P=0.026),sphenoid sinus type (P=0.003),sella type morphology (P=0.046),diameter of diaphragmatic opening (P=0.003) and maximum width of the sphenoid sinus septum (P=0.009) were the independent predictors influencing the main expansion direction of pituitary macroadenomas in the vertical direction.Conclusions The pituitary macroadenoma is more likely to expand infrasellar in patients with sellar or sellaoccipital sphenoid sinus,sac sella turcica morphology,GH adenoma,smaller diaphragmatic opening diameter and narrower width of sphenoid sinus septum.The pituitary macroadenoma is more likely to expand suprasellar in patients with presellar sphenoid sinus,wok and cylinder sella turcica morphology,nonGH adenoma,larger diaphragmatic opening diameter and wider width of sphenoid sinus septum.