【摘要】 目的　研究垂体大及巨大腺瘤经蝶入路显微手术治疗中应用影像定位与手术疗效的关系。方法　1987年 1月至 2 0 0 1年 2月经蝶入路显微切除的 2 4 5例大及巨大垂体腺瘤 ,术中应用C 臂X光机或Zeiss自动调焦平衡架显微镜内、外影像导航系统 ,在经蝶入路及切除肿瘤过程中进行影像定位 ,术后对患者进行长期连续随访 ,以探讨术中影像定位与手术疗效的关系。结果　 2 4 5例患者术后脑脊液漏 2 8例 ,占 11 4 % ;暂时性尿崩 2 6例 ,占10 6 % ;垂体功能低下 10例 ,占 4 1% ,全部病例无死亡。随访 176例患者 ,影像复查全切除 96例 ,全切率 5 4 5 % ,术后 1年以上肿瘤复发 2 1例 ,复发率 11 9%。结论　在大及巨大垂体腺瘤经蝶入路显微手术中应用影像定位有助于提高手术全切率 ,减少手术并发症及肿瘤复发率。更多还原

【Abstract】 Objective To analyze the relationship between image orientation and surgical effect in transsphenoidal microsurgery of pituitary macroadenoma. Methods Between January 1987 and February 2001, 245 patients with large & giant pituitary adenoma undergoing surgery via transsphenoidal route were studied. We took great advantage of C arm X ray machine or Zeiss self focus balance frame microscopic image directional system. During operation, tumor was underwent image orientation. We also gave the patients long term follow up study after operation in order to discuss the relationship between intra operative image orientation and surgical effect. Results Among 245 cases, 28 patients(11.4%) suffered with cerebral spinal fluid rhinorrhea, Temporary diabetes insipidus was presented in 26 cases (10.6%), and postoperative hypopituitarisom was found in 10 cases (4.1%). No patient died from operation. Postoperative image was obtained during follow up in 176 patients and 96 cases (54.5%) showed complete removal. 21 cases (11.9%) relapsed one year after operation. Conclusions In microsurgical therapy of patients with large & giant pituitary adenoma, it’s useful to increase surgical total removal rate, decrease operative complication and tumor relapse rate by using of image orientation during operation.更多还原