经蝶手术治疗巨大型垂体腺瘤并发症分析

目的 总结经蝶手术治疗大型和巨型垂体腺瘤的经验及并发症的处理,提高临床治疗效果.方法 鼻前庭小柱切开增加侧斜切口,后经鼻中隔-蝶窦中线处凿开鞍底,切除鞍内肿瘤.结果 140例中行包膜内全切除48例（31%）,其余行次全切除或大部分切除.术后症状立即改善者122例（90%）;术后部分病例出现暂时性尿崩症、鼻腔渗血、脑脊液鼻漏和垂体功能低下等经对症治疗而好转.结论 诸多环节影响大型和巨型垂体腺瘤经蝶手术治疗效果,手术并发症值得重视.

Clinical analysis of complicatios of transsphenoidal surgery in treatment of giant pituitary adenoma

Objective To explore experiences of complications in removal of patients with large and giant pi-tuitary adenonms by transsphenoidal approach and to improve the clinical treatment effectiveness.Method Nasal vestibule small column was cut to increase inclinometer incision,then the bottom of sellar was broken via the nasal septum-the midline of sellar sphenoid sinus and intrasellar tumor was removed.Results The tumor was totally re-moved on 48 patients(31%)and sub-totally or partly removed on other patients.The 122(90%) patients'symptoms or signs were greatly improved in following days.There wore cerebrospinal fluid rhinorrhea(thirteen cases),nasal bleed-ing,diabetes incipidus which lasted for one week or more and were cured by treatment with drugs.Conclusion As to complications in removal of patients with large and giant pituitary adenomas by transsphenoidal approach,many poly-nucleations in fluenced the effect and should be reconstructed.