单侧鼻孔经蝶微侵袭垂体腺瘤手术治疗

目的　总结单侧鼻孔经蝶入路垂体腺瘤切除术的手术经验及体会。方法　对 115例垂体腺瘤病人采用经单鼻孔蝶窦入路行显微镜下垂体腺瘤切除手术 ,其中垂体微腺瘤 7例 ,大腺瘤 79例 ,巨大腺瘤 2 9例 (其中累及海绵窦者 6例 ,肿瘤卒中 2例 )。结果　 10 0例肿瘤获全切 ,目前4例复发 ,其中 3例二次手术 ,10例大部切除 ,5例部分切除。所有病人术后内分泌症状均有不同程度改善。术后尿崩症 15例 ,经治疗出院时均恢复正常 ,1例术后单眼视力较术前明显下降 ,脑脊液鼻漏 2例 ,术后嗅觉丧失 2例。结论　此入路有手术距离缩短、损伤小、省时、简单、并发症少等优点。

Resection of pituitary adenoma via transnasal-transsphenoidal approach

Objective To introduce the experience of resection of pituitary adenamas by single-nostril transsphenoidal microscopic surgery. Methods 115 patients with pituitary adenomas were treated through the single-nostril transsphenoidal microscopic operation. All cases were distributed into 7 microadenamas, 79 macroadenomas and 29 huge adenomas. Results Completely removing was achieved in 100 cases, most partial resection in 10 cases and partial resection in 5 case. Transient diabetes insipidus with water-electrolyte disorder occurred in 15 and CSF leaking in 2 cases. Severe vision damage occurred in 1 case and anosmia in 2 cases after operation. Conclusion Single-nostril transsphenoidal microscopic surgery has advantages of less destruction, shorter operating time, less complication and easy to be performed.