神经导航在经蝶窦显微手术治疗垂体腺瘤中的应用

目的评价神经导航系统在经蝶入路垂体腺瘤切除手术中的应用。方法对23例垂体腺瘤患者于术前在导航系统工作站中进行图像三维重建，制定手术计划，标记重要结构。术中应用导舷威导舷棒定位，指导手术操作。结果术中导航系统定位准确，平均误差1．7mm。肿瘤全切除18例（78．2绚，次全切除5例（21．8%）。术后视力及视野改善94．1％。内分泌指标术后均有改善。术后主要尿崩、脑脊液鼻漏。结论神经导航系统辅助经蝶窦切除垂体腺瘤手术定位准确，安全性高，有利于提高肿瘤切除率，减少手术并发症。

Transsphenoidal microsurgical resection of pituitary adenomas under neuronavigation

Objective] To evaluate the effect of neuronavigation system guided transsphenoidal resection of pituitary adenomas. Methods] 23 patients accepted images reconstruction,operation plan design and important structures mark were finished in the workstation of navigation system before surgery.All the operation procedures were done under the guide of navigation system. Results] The tumor was accurately located with neuronavigation system, and mean error was 1.7mm.Total resection was performed in 18 cases(78.2%) and subtotal resection in 5 cases(21.8%). Visual acuity were relieved in 94.1%.Postoperative endocrine secretion improved in all cases. Major complication was transient diabetes insipidus and cerebrospinal fluid leakage occured. Conclusions] Neuronavigation system is quite useful for accurate location,raising the tumor removal rate and reducing the surgical complications.