【摘要】 目的探讨神经内窥镜技术在垂体腺瘤切除术中的应用方式及特点。方法在32例垂体腺瘤切除术中使用了神经内窥镜。其中15例采用内镜辅助下眶上“锁孔”入路垂体腺瘤显微切除术,17例采用神经内镜控制下经单鼻孔-蝶窦入路垂体腺瘤切除术。结果本组32例术后无1例死亡,无1例出现颅内出血、视神经损伤、颈内动脉损伤及脑脊液鼻漏等现象。用内镜控制的经单鼻孔-蝶窦入路垂体腺瘤切除术的17例病例中,15例肿瘤全切,1例肿瘤近全切除,1例肿瘤大部分切除。用内镜辅助的经眉切口眶上“锁孔”入路垂体腺瘤显微切除术的15例病例中,14例肿瘤全切,1例肿瘤近全切除。2例病人术后出现一过性多尿。本组32例患者术后随访3～15个月,原有症状均有所改善,异常增高的激素水平均降至正常,MRI检查显示无1例肿瘤复发。结论内镜辅助下经眉切口眶上“锁孔”入路垂体腺瘤显微切除术和内镜控制下经单鼻孔-蝶窦入路垂体腺瘤切除术符合微创原则,术后并发症少,疗效满意。提倡在垂体腺瘤切除术中使用神经内窥镜技术。更多还原

【Abstract】 Objective To investigate the way and characteristics of application of endoscope in pituitary adenoma resection. Methods Endoscopic technique was used in pituitary adenoma resection for 32 patients. 17 treated with the single-nostril transsphenoidal endoscopic pituitary adenoma surgery and 15 treated with endoscope -assisted microneurosurgery via transeyebrow supraorbital keyhole approach. Results There was no mortality in 32 cases. No cerebral hemorrhage, cerebrospinal rhinorrhea, optic nerves injury, internal carotid injury, or other complications occurred. Of 17 patients receiving the single-nostril transsphenoidal endoscopic pituitary adenoma surgery, 15 patients underwent total resection, 1 patient subtotal resection and 1 most resection. Of the 15 patients receiving endoscope-assisted microneurosurgery of pituitary adenoma via transeyebrow suppraorbital keyhole approach, 14 patients underwent total resection and 1 subtotal resection. 2 cases suffered from temporary diabetes insipidus after the surgery,In 3-15 months follow-up, the symptoms of headache, visual disturbance, etc. were alleviated or improved, and the hormone levels resumed to normal postoperatively and no recurrence occurred by MRI. Conclusion The single-nostril transsphenoidal endoscopic pituitary adenoma surgery and endoscope -assisted microneurosurgery of pituitary adenoma via transeyebrow supraorbital keyhole approach as promising minimally invasive procedure, is definitely advantageous in pituitary adenoma resection.更多还原