垂体腺瘤；蝶窦；显微外科；手术____

经单鼻孔蝶窦入路垂体腺瘤切除45例分析

http://www.100md.com 《局解手术学杂志》 2007年第1期

垂体腺瘤；蝶窦；显微外科；手术,,],垂体腺瘤；蝶窦；显微外科；手术,1资料与方法,2结果,3讨论,[参考文献]

     [摘要]目的探讨经单鼻孔蝶窦入路显微手术垂体腺瘤切除的方法和效果。方法对45例垂体腺瘤患者采用经单鼻孔蝶窦入路显微手术切除6例微腺瘤及39例大腺瘤，其中泌乳素(PRL)腺瘤18例，生长激素(GH)腺瘤8例，混合性(PRL+GH或PRL+ACTH)腺瘤12例，无功能性腺瘤7例。结果显微镜下全切除43例，次全切除2例。术后一过性尿崩症28例，经治疗1周左右恢复。无手术死亡、脑脊液鼻漏、术区出血及脑膜炎等并发症。术后平均住院8 d，全组病例术中未输血；随访1~5年，1例复发。结论单鼻孔经蝶窦入路较传统经蝶入路具有安全、简便、微创、术后并发症少、恢复快、效果满意等优点，是鞍内肿瘤切除的良好径路。

    [关键词] 垂体腺瘤；蝶窦；显微外科；手术

    Singlenostril transsphenoidal pituitary adenoma microsurgery in 45 cases

    MA Yuxin, YIN Linxiang, MAO Peijun, LI Baiyuan, BAI Haiping, LI Zengsheng, ZHANG Wei, CHEN Huanran, AN Ning, HE Jiaquan, YANG Hui

    (Department of Neurosurgery, the 323rd Hospital of PLA, Xi’an 710054, China)

    Abstract： ObjectiveTo study the methods and evaluate the clinical effects of Singlenostril transsphenoidal pituitary adenoma microsurgery. Methods45 pituitary adenoma patients accepted Singlenostril transsphenoidal pituitary adenoma microsurgery, including 6 cases minute and 39 cases large adenoma. 18 cases were PRL adenoma, 8 cases were GH adenoma, mixed type (including PRL plus GH type or PRL plus ACTH type) and no functional adenoma 7 cases. Results43 cases accepted total resection and 2 cases deuto total resection. 28 cases had temple diabetes insipidus after surgery and recovered by one week's treatment. There were no complications such as death, cerebrospinal rhinorrhea, hemorrhage and so on .in the surgery region and meningitis. The mean 8 days in hospital after surgery. All the cases had no blood transfusion during surgery. The longest following up visit was 5 years, and 1 case recurred.ConclusionSinglenostril transsphenoidal microsurgery was safe, convenient microinsult, minor complications and fast recovering comparing with traditional approach. It was an effective and satisfactory approach to cut the intrasaddle tumor. ......

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