【摘要】 目的为了提高大型、巨大型垂体腺瘤经口鼻蝶窦显微手术全切除率。方法15例患者手术中采用美国Datex.ohmeda7100型麻醉机。静脉和吸入复合麻醉,呼吸机控制呼吸。肿瘤切除过程中发现鞍隔下降不满意时,关闭机械通气开关,行人工通气控制呼吸分次行短暂气道加压使气道压达到50~70cmH2O。术中观察鞍隔下降程度。术后3个月复查MRI评价肿瘤切除程度。结果15例患者中14例鞍隔下降达到扩大蝶鞍的鞍中或鞍底水平。术后复查MRI13例患者肿瘤全切除,全切除率86.7%。所有患者视力、视野有明显改善。结论在大型、巨大型垂体腺瘤经蝶窦切除术中应用短暂气道加压法安全、有效,可以提高肿瘤全切除率。更多还原

【Abstract】 Objective To raise complete resection ratio of large and tremendous pituitary adenoma via microsurgery transsphenoidal approach.Method Datex·ohaeda7100type anaesthesia machine was applied in15cases with pituitary adenoma microsurgery procedure.15cases were used combined vein with inhalational anesthesia,in which respiration was reigned by anaesthesia machine.Respiration was controlled by men and mechanical ventilation switch was turned off when it was observed that sella diaphragma incompletely descended in15cases.Respiration tract pressure was gradually increased to50～70cm H 2 O with transient compression in respiration tract.Height of sella diaphragna was obˉserved in surgery procedure.15cases were performed MRI scanning to evaluate the size of remaining pituitary adenoma after3months of surgery.Result Sella diaphragma of13cases descended to enˉlarged sella middle or sella floor height in our study.Pituitary adenoma of13cases were completely resected in MRI imaging.Complete resection ratio of pituitary adenoma was86.7%.Vision and visual field of15cases were significantly improved.Conclusion Complete ratio of large and tremendous piˉtuitary adenoma can be improved by using transient respiration tract compression through microsurgery transsphenoidal approach.更多还原