Pituitary adenoma
Conditions
Interventions
STER:200 mg Hydrocortisone (HC) was given by intravenous injection (iv) during the operation.200 mg of hydrocortisone was administered intravenously in the first 24 hours after surgery (Post-operativ
POD 3 HC 50 mg iv
POD 4 HC 25 mg iv
POD 5-14 Cortisone acetate (CA) 25 mg oral (po).
LESS-STER:Steroid hormones were not used during surgery and were grouped according to POD 1 plasma Cortisol (COR) levels at 8:00 AM (0800) :
A, group SAI (COR < 5 µg/dL, or COR 5-15 µg/dL, with clini
B, group NOSAI (COR = 5 µg/dL and no clinical symptoms of adrenal cortical dysfunction) : no steroid hormones.
Sponsors
Shanghai East Hospital, School of Medicine, Tongji University
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Inclusion criteria
Inclusion criteria: Age =18 years and <80 years; Imaging diagnosis + postoperative pathology confirmed pituitary adenoma; Patients who have not received medical treatment for pituitary adenoma; All underwent neuroendoscopic transsphenoidal sinus resection (TSS); The hypothalamic-pituitary-adrenal (HPA) axis function was normal (preoperative plasma cortisol level = 5 µg/dL at 8 am (0800)) and there were no clinical symptoms of adrenal insufficiency; Patients have understood the nature of the study, voluntarily participated in this trial and signed informed consent.
Exclusion criteria
Exclusion criteria: Hypothalamic-pituitary-adrenal (HPA) axis dysfunction (preoperative at 8 am (0800) plasma cortisol levels COR < 5 µg/dL, or COR 5-15 µg/dL, Clinical symptoms associated with adrenal insufficiency (hypotension, bradycardia, nausea, fatigue, severe headache, persistent vomiting, or severe hyponatraemia (< 125 mmol/L)); Known allergic history of the drug ingredients in this study; Cushing's disease; Pituitary apoplexy; Recurrent pituitary adenoma; Invasive pituitary adenoma (Knosp III, IV or Hardy 3, 4); Previous history of craniocerebral surgery and major trauma; Patients with a history of glucocorticoid use within 4 weeks prior to surgery; Patients with prior adrenal dysfunction; Upper digestive tract bleeding from gastric ulcer; Femoral head necrosis without surgical treatment; Serious abnormal function of important organs; Nasal or intracranial infection; The pregnant woman; The researchers believe that there are any circumstances that are not suitable for inclusion.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Ratio of newly diagnosed secondary adrenal insufficiency SAI patients on 7 days after surgery; | — |
Secondary
| Measure | Time frame |
|---|---|
| Ratio of newly diagnosed secondary adrenal insufficiency SAI patients on 14 days after surgery; | — |
Countries
China
Contacts
Public ContactChunlong Zhong
Shanghai East Hospital, School of Medicine, Tongji University
Outcome results
None listed