巨大垂体腺瘤切除术中的垂体柄保护及意义

目的 探讨巨大型垂体腺瘤切除手术中的垂体柄保护。方法 采用经纵裂蝶窦入路显微手术切除巨大型垂体腺瘤52例。结果 肿瘤全切除39例（75％）。垂体柄保留34例（65％）。术后发生尿崩32例（62％），其中23例在术后1－2周内恢复正常，占术后尿崩总数的72％；7例在3个月内恢复；2例尿崩症状持续1年以上。结论 垂体腺瘤手术中的垂体柄保留可有效降低术后尿崩症，特别是永久性尿崩症的发生，是提高手术效果的重要措施。

Preservation of pituitary stalk in total removal of gaint pituitary adenoma

Objective To discuss the protection of pituitary stalk in the microsurgical removal of gaint pituitary adenomas.Methods 52 cases were treated by the interhemisphericapproach.Results Total removal of the tumor were got in 39 cases(75%).The pituitary stalks were reserved in 34 cases (65%). After the operation 32 cases suffered from diabetes insipidus(62%).Among these 32 patients,23 cases recovered in 1 to 2 weeks after operation (72%),7 cases recovered in 3 monthes. Diabetes insipidus continued over 1 year in 2 cases.Conclusions Reserving the pituitary stalk in the microsurgical removal of gaint pituitary adenomas could reduce the incideuce of postoperative diabetes insipidus,especially reduce the permanent diabetes insipidus. It is the key point to improve the operative effect.