显微外科治疗大及巨大垂体腺瘤手术入路的探讨

目的 探讨显微外科治疗大及巨大垂体腺瘤手术方法的选择。方法 对CT或MRI证实的56例大及巨大垂体腺瘤，采用经蝶入路或经颅入路两种手术方法，在显微镜下切除肿瘤。结果 经蝶手术18例，全切除12例，次全切除6例，无一例死亡。经颅采用翼点或经额入路显微手术治疗38例，经额手术25例，全切除22例，次全切2例，部分切除1例，其中1例死亡．原因不明；经翼点13例，全切除10例，次全切2例，部分切除1例，无一例死亡。结论 采用显微外科技术，针对肿瘤的特点选择不同的手术入路是提高垂体腺瘤全切率、降低死亡率的关键。

Surgical approach of microsurgical treatment of large or huge pituitary adenoma

Objective To explore the choice of operative approaches in the microsurgical treatment of pituitary adenomas. Methods Fifty-six patients with large or huge pituitary adenomas demonstrated on CT or MRI were treated by microsurgery through the transsphenoidal or transcranial approach. The curative effects of the 2 operative approaches were compared. Results Of the 18 patients operated on via the sphenoidal approach, 12 the total resection, and 6 subtotal; none died. Of the 25 patients operated on via the frontal approach, 22 achieved total resection, 2 subtotal and 1 partial; 1 case died of the unknown reason. Of the 13 patients operated on via the pterional approach, 10 received the total resection, 2 subtotal and 1 partial; no death occurred. Conclusion The key to increasing the rate of total resection and to decreasing death rate is to select an operative approach proper for the tumor characteristics in the patients with pituitary adenomas.