耿军 陈明振 黄正松 吴新建 陈晓雷 中山医科大学附属第一医院神经外科 510080 中国神经精神疾病杂志 2000 0 26 5


    关键词：垂体腺瘤；经蝶入路；手术切口；鞍底修复 期刊 zgsjjsjbzz 0 283-285 论著与学术交流 fur -->/info/meeting/meeting02.asp?keyword=神经病学


    

【摘要】 目的 探讨经蝶垂体腺瘤手术有关切口、鞍底修复等改良方法的优越性。方法 对71例经蝶垂体腺瘤(包括微腺瘤10例，鞍内大腺瘤26例，向鞍上扩展的大腺瘤19例，侵及海绵窦并向鞍上扩展的大腺瘤11例，复发性垂体腺瘤5例)手术采用单侧鼻内粘膜切口，49例肿瘤残腔及鞍底修复皆简化为仅用Tachocomb粘贴，骨性鼻中隔回复两侧粘膜之间原位。结果 本组肿瘤全切除56例，次全切除15例。视力下降者术后视力皆在短期内获得明显改善，无1例并发脑膜炎、鼻中隔穿孔。49例鞍底修复采用Tachocomb者，无1例发生术后脑脊液漏。术后随访2个月至4年，5例肿瘤复发再次手术，66例生活自理，40例恢复原工作。结论 这些手术方法的改良简化并方便了手术，减少了损伤，防止了术后脑脊液漏、鼻中隔穿孔等并发症。

Endonasalincision and modified repairation of sella floor in transsphenoidl pituitary surgery

Geng Jun Chen Mingzeng Huan Zhenshong Wu Xingjian Chen Xiaolei

    (Department of Neurosurgery, First Affiliatedhospital of Sun Yat-sen University of Medical Sciences, 58, Zhongshan Road Ⅱ, Guangzhou. 510080. Tel: 020-87755766-8213 )

【Abstract 】Objective To study theadvantage of modified methods regarding incision and repairation of sella floor intranssphenoidal approach for pituitury tumor removal.Method The transsphenoidal approach with unilateral incision of endonasalmucosa was performed for resecting pituitary tumor in 71 patients. Tachocombs were usedfor repairation of the sella floor in 49 cases. Results Of all 71 patiants, total resection of the tumor was performed in56 and subtotal resection in 15. No patient was complicated by postoperative meningitisand rhinosetal perforation. Of the 49 cases with repairation of sella floor by Tachocombs,there was no case of postoperative CSF leakage.Conclusions Endonasal incision and modified repairation may simplify operativeprocedure, reduced damage and prevent postoperative complications of CSF leakage andrhinoseptal perforation.

     【Key words 】 Pituitary tumor Transsphenoidalapproach Incision Sella floor repairration

基于多年来采用唇下-鼻中隔入路及鼻小柱入路经蝶垂体瘤手术的经验 ......