内镜经鼻蝶窦垂体瘤术后短期并发症的临床分析

目的 评估内镜经鼻蝶窦垂体瘤术后短期并发症(术后即刻至术后60 d).方法 回顾性分析2007年9月至2008年8月新疆医科大学第一附属医院神经外科连续收治的114例垂体瘤患者行内镜经鼻蝶窦手术的临床资料,记录短期并发症的发生,探讨其发生的原因.结果 本组114例垂体瘤患者行内镜经鼻蝶窦手术,肿瘤全切89例,次全切除11例,部分切除14例,其中死亡3例.28例患者出现11种短期并发症,同时出现4种并发症的患者4例,同时出现3种并发症的患者8例,同时出现2种并发症的患者13例,仅有一种并发症的患者3例.结论 内镜经鼻蝶窦垂体瘤手术短期并发症与肿瘤本身的特点(生长方向、是否侵袭性等)有关,与手术技术的熟练程度和特殊手术器械有关.需要经历较长的学习平台期.

Short-term complications associated with endoscopic transnaso - sphenoidal approach for pituitary adenoma surgery

Objective To evaluate the short -term complications related to the endoscopic transnaso - sphenoidal approach for pituitary adenoma surgery. Method A retrospective analysis was conducted in 114 patients with pituitary adenomas who underwent endoscopic transnaso - sphenoidal approach surgery between September 2007 and August 2008 in the first affiliated hospital of Xinjiang medical college. The short - term (within 60 days after operation) complications were recorded. The potential causes of complications were studied. Results The numbers of patients of gross total,subtotal and partial removal of tumors were 89,11 and 14 respectively. The short - term complications were found in 28 patients. Four patients suffered from 4 kinds of complications simultaneously. There were 8 patients with 3 kinds of complications. 13 patients harbored 2 kinds of complications. And 3 patients only had one complication. Conclusions Complications of endoscopic transnaso -sphenoidal approach procedure is related not only to the characteristic of tumor,but also to surgical skills and special instruments. Surgeon need a long learning -curve to master the technique.