摘要目的：评估垂体瘤术后内分泌代谢紊乱情况，并分析激素替代治疗效果。方法选取2013年6月至2014年2月垂体瘤患者78例为研究对象，均择期行垂体瘤术，比较患者术前、术后3 d、术后3个月、术后1年游离三碘甲状腺原氨酸（FT3）、促甲状腺激素（TSH）、游离甲状腺激素（FT4）、皮质醇（ PTC）、促肾上腺皮质激素（ACTH）水平，同时对术后3 d 出现垂体功能减退者给予左旋甲状腺激素和强的松进行替代治疗，分析1年内激素替代治疗效果，并观察患者的不良反应。结果术后3 d 患者 FT3[（2.18±0.96）mol/ L]、TSH[（0.57±0.32）mU/ L]、FT4[（11.42±2.15）pmol/ L]、PTC[（0.16±0.02）μmol/ L]、ACTH[（6.31±1.59）ng/ L]明显低于术前、术后3个月、术后1年（P ﹤0.05），而术前、术后3个月、术后1年上述激素水平两两比较差异未见统计学意义（P ﹥0.05）；术后50例出现垂体功能减退，发生率为64.10%，激素替代治疗有效率为86.00%，不良反应发生率为10.00%。结论垂体瘤术后患者存在腺垂体内分泌代谢紊乱，尤其在术后3 d 内需及时监测，并进行激素替代治疗。

abstractsObjective To assess the postoperative pituitary tumor endocrine metabolic disturb-ance,and analyze the treatment effect of hormone replacement therapy. Methods Seventy-eight patients with hypophysoma treated from June 2013 to February 2014 were selected as the research objects. They underwent selective pituitary tumor surgery,the free triiodothyronine(FT3),thyrotrophin(TSH),free thyroid hormone(FT4),cortisol(PTC),adrenocorticotro(ACTH)levels before the operation,postop-erative 3 d,postoperative 3 months,postoperative 1 year were compared,the patients with hypopituita-rism within postoperative 3 d were given left thyroid hormone and metacortandracin to conduct replace-ment therapy,the treatment effects of hormone replacement therapy within 1 year were analyzed,and the adverse reactions were observed. Results The levels of FT3[(2. 18 ± 0. 96)mol/ L],TSH[(0. 57 ± 0. 32)mU/ L],FT4[(11. 42 ± 2. 15)pmol/ L],PTC[(0. 16 ± 0. 02)μmol/ L],ACTH[(6. 31 ± 1. 59)ng / L]of patients postoperative 3 d were significantly lower than those before operation,postopera-tive 3 months,postoperative 1 year(P ﹤ 0. 05),there was no significant difference in above hormone levels before the operation,postoperative 3 months,postoperative 1 year(P ﹥ 0. 05);hypopituitarism occurred in 50 cases after the operation,the occurrence rate was 64. 10% ,and the effective rate of hor-mone replacement therapy was 86. 00% , the incidence of adverse reactions was 10. 00% . Conclusions Adenohypophysis endocrine metabolic disturbance occur in postoperative pituitary tumor patients,timely monitoring is needed especially in postoperative 3 d,and conduct hormone replacement therapy.