【摘要】 目的探讨经鼻蝶垂体腺瘤切除手术出血并发症的原因及处理方法。方法回顾性研究104例经鼻蝶垂体腺瘤切除手术发生出血并发症病人的临床资料,出血后保守治疗82例,再次手术治疗22例。结果鞍上远隔部出血8例,痊愈3例,长期昏迷1例,死亡4例;颈内动脉出血5例,痊愈4例,死亡1例;瘤腔内出血38例,痊愈25例,视力下降7例,动眼神经麻痹2例,长期昏迷1例,死亡3例;鼻腔出血53例,均获得满意止血。结论出血是经鼻蝶垂体腺瘤手术的常见并发症,大多预后良好,少数严重出血可危及生命;提高显微手术技巧和总结经验教训可减少和避免手术出血并发症。更多还原

【Abstract】 Objective To investigate the causes and management of hemorrhage in trans-naso-sphenoidal surgery for pituitary adenomas.Methods Clinical data of 104 patients with hemorrhage in trans-naso-sphenoidal surgery for pituitary adenomas were analyzed retrospectively.Conservative treatment was performed in 82 patients and reoperation in 22.Results Hemorrhage occurred in distant suprasellar area in 8 patients,including recovery in 3,long-term coma in 1 and death in 4 after treatment.Hemorrhage occurred in internal carotid arteries in 5 patients,including recovery in 4 and death in 1.Hemorrhage occurred in tumor cavities in 38 patients,including recovery in 25,impaired vision in 7,oculomotor paralysis in 2,long-term coma in 1 and death in 3.Hemorrhage occurred in nasal cavity in 53 patients and obtained satisfactory result with hemostasis.Conclusions Hemorrhage is a common complication in trans-naso-sphenoidal surgery for pituitary adenoma.Most patients have good prognosis except for a few serious life-threatening cases.Improving the microsurgical skill and drawing lessons from the past can reduce or avoid the complications of hemorrhage.更多还原