【摘要】 目的探讨经单鼻孔蝶窦入路显微切除垂体瘤的手术方法及总结经验。方法选取滁州市第一人民医院26例垂体瘤患者(全部经单鼻孔蝶窦入路显微手术切除)的临床资料,对手术入路、术中操作、并发症的处理进行临床分析。结果 26例垂体腺瘤患者中,泌乳素(PRL)分泌性腺瘤10例;生长激素(GH)分泌性腺瘤6例;PRL和GH混合性腺瘤2例;非分泌性腺瘤8例,肿瘤全切18例,次全切除5例,大部分切除3例。发生电解质紊乱1例,暂时性尿崩症5例,无永久性尿崩症,脑脊液鼻漏2例,持续2周,无需再次手术。结论与开颅垂体瘤切除手术相比,经蝶窦入路手术明显降低了病死率和伤残率,是治疗垂体瘤的首选入路之一,严格把握好手术适应症和禁忌症,能使需要手术治疗的垂体瘤患者取得满意的治疗效果。更多还原

【Abstract】 Objective To study the technique and experience of single-nostril transsphenoidal pituitary adenoma microsurgery.Methods Clinical data of 26 patients undergoing transsphenoidal microsurgery for pituitary adenomas was analyzed,the surgical approach,operation and treatment of complications were evaluated.Results Among the 26 cases,10 cases were PRL adenoma,6 cases were GH adenoma,mixed type 2 cases and no functional adenoma 7 cases.18 cases accepted total resection,5 cases sub-total resection and 3 cases most tumors resection.After surgery,electrolyte imbalance occurred in 1 cases,transient diabetes insipidus in 5 cases and no permanent diabetes insipidus,2 cases with CSF rhinorrhea lasting for two weeks and needing no reoperation.Conclusion Compared with craniotomy for pituitary tumor resection surgery,transsphenoidal surgery significantly reduced mortality and disability rates,which was the preferred approach for the treatment of pituitary tumors.Strictly grasp the good surgical indications and contraindications,which can make the surgical treatment of pituitary tumors to achieve a satisfactory therapeutic effect.更多还原