神经内镜在经蝶窦垂体瘤切除手术中的应用

目的探讨神经内镜在经蝶手术中的临床意义。方法回顾性总结及分析我科自2004年5月~2009年1月5年间神经内镜下经蝶窦垂体瘤切除手术56例患者的临床资料,术前均行影像学（CT和MRI）及血液内分泌激素检查,且均在内镜下经鼻蝶手术切除病变。50例获得6~24个月的随访。结果肿瘤全切例39例（69.6%）,次全切除12例（21.4%）,部分切除5例（9%）。术后临床症状改善50例（89.2%）。50例随访病人中,4例在术后2年内复发。结论内镜经鼻蝶手术治疗垂体瘤,创伤小,切除肿瘤相对完全,术后病人反应轻,住院时间短。神经内镜下经蝶窦垂体瘤切除手术是一种有效的微侵袭手术方法。

Treatment of pituitary tumors via endoscopic endonasal transsphenoidal approach

Objective：to explore the clinical significance of neuroendoscopy in transsphenoidalsurgery.Methods：From May 2004 to May 2006,56 cases of pituitary adenoma were treated by endoscopic endonasal transsphenoidal surgery.All the patients received neuroimaging（MRandCT） and endocrinological examinations before the surgery.50 patients got follow-up of 6-24 months.Results： The tumor removal was totalin39（69.6%） cases,subtotalin12（21.4%）and partialin 5（9%）.50（98%） patients achieved an improvement in clinical symptom after the operation.Among the 50 follow-up patients,4 had relapse at 2 years after the first operation.Conclusion： The endoscopic transsphenoidal surgeryfor pituitary tumors is of advantages as minimal invasiveness,mild response,complete resection of tumor,and shorter hospitalization time.It is a good choice to cure the pituitary tumors with endoscopic endonasal transsphenoidal approach.