经单鼻孔蝶窦入路切除垂体腺瘤临床分析

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122例垂体腺瘤患者采用经单鼻孔蝶窦入路显微手术切除,其中生长激素腺瘤38例,高泌乳素腺瘤54例,促肾上腺皮质素腺瘤19例,无功能腺瘤11例.结果 显微镜下全切除89例,次全切除33例.术后一过性尿崩症18例,13例并发脑脊液漏,经治疗2周左右恢复.无手术死亡及脑膜炎等并发症.术后平均住院8 d,所有患者术中未输血;随访6个月未复发.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.

Pituitary adenoma resection with single nostril transsphenoidal approach

Objective To study the methods and evaluate the clinical effects of Singlenostril transsphenoi-dal pituitary adenoma microsurgery. Methods One hundred and twenty-two pituitary adenoma patients received Singlenostril transsphenoidal pituitary adenoma microsurgery, 38 cases were GH adenoma, 54 cases were PRL ade-noma, 19 cases were ACTH adenoma and 11 caseswere no functional adenoma. Results Eighty-nine cases received total resection and 33 cases had deuto total resection. 18 cases had temple diabetes insipidus. 13 cases had cerehro-spinal rhinorrhea after surgery and recovered with two weeks' treatment. There were no complications such as death, hemorrhage. The mean postoperative hospitalization was 8 days. All cases had no blood transfusion during surgery. The following up visit was 6 months. Conclusion Singlenostril transsphenoidal microsurgery is a safe and conven-ient microinsult with minor complications and fast recovery compared with traditional approach. It is an effective ap-proach to remove intrasaddle tumor.