Chinese General Practice ›› 2022, Vol. 25 ›› Issue (36): 4491-4495.DOI: 10.12114/j.issn.1007-9572.2022.0436
Special Issue: 指南/共识最新文章合集
• Guide Interpretation • Previous Articles Next Articles
Received:
2022-03-14
Revised:
2022-07-25
Published:
2022-12-20
Online:
2022-08-25
Contact:
CHEN Shuchun
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通讯作者:
陈树春
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URL: https://www.chinagp.net/EN/10.12114/j.issn.1007-9572.2022.0436
阶段 | 无功能性腺瘤 | 泌乳素瘤 | 肢端肥大症 | 库欣病 |
---|---|---|---|---|
妊娠前 | 腺瘤位于视交叉附近的患者,可以通过手术降低视交叉受压风险并提高生育能力 | 即使是轻度的高泌乳素血症,也应使用最低的剂量卡麦角林使之正常化,以优化受孕机会 | 手术治疗活动性肢端肥大症 | 不建议处于疾病活动期的患者妊娠 |
妊娠期 | 腺瘤生长的风险较低,无需常规监测 | 确认妊娠后应停止药物治疗。但巨乳素瘤的患者需要密切监测泌乳素水平 | 通常情况下无需监测生长激素和/或类胰岛素样生长因子1,确认妊娠后应停止医疗 | 其诊断和活动性评估具有挑战性,但昼夜分泌节律仍然存在 |
分娩后 | 建议分娩后3~6个月重新进行垂体成像和功能评估 | 很大比例的患者在分娩后生化指标可得到缓解 | 常见疾病的活动性反弹 | 分娩后2~3个月重新评估疾病活动性 |
Table 1 Core suggestions for the management of non-functioning pituitary adenomas,prolactinoma,acromegaly,and Cushing's disease during pre-pregnancy,intra-pregnancy and postpartum periods in the ESE Clinical Practice Guideline on Functioning and Non-functioning Pituitary Adenomas in Pregnancy
阶段 | 无功能性腺瘤 | 泌乳素瘤 | 肢端肥大症 | 库欣病 |
---|---|---|---|---|
妊娠前 | 腺瘤位于视交叉附近的患者,可以通过手术降低视交叉受压风险并提高生育能力 | 即使是轻度的高泌乳素血症,也应使用最低的剂量卡麦角林使之正常化,以优化受孕机会 | 手术治疗活动性肢端肥大症 | 不建议处于疾病活动期的患者妊娠 |
妊娠期 | 腺瘤生长的风险较低,无需常规监测 | 确认妊娠后应停止药物治疗。但巨乳素瘤的患者需要密切监测泌乳素水平 | 通常情况下无需监测生长激素和/或类胰岛素样生长因子1,确认妊娠后应停止医疗 | 其诊断和活动性评估具有挑战性,但昼夜分泌节律仍然存在 |
分娩后 | 建议分娩后3~6个月重新进行垂体成像和功能评估 | 很大比例的患者在分娩后生化指标可得到缓解 | 常见疾病的活动性反弹 | 分娩后2~3个月重新评估疾病活动性 |
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