经鼻蝶入路显微手术切除垂体腺瘤63例

目的总结经鼻蝶入路垂体腺瘤显微切除术的治疗经验。方法回顾性分析2008年7月至2010年6月收治的63例行经鼻蝶垂体腺瘤显微切除术患者的临床资料,对手术适应症、术前病人管理、手术经验技巧以及术后并发症的预防和处理进行总结及分析。结果本组63例患者均行经鼻蝶垂体腺瘤显微切除术,无死亡病人;肿瘤全切54例,大部分切除8例。1例侵袭性垂体瘤患者术后两年复发。手术全切率85.7%(54/63),92.7%(38/41)视力下降病人视力得到改善,内分泌症状改善者达88.0%(44/50)。结论经鼻蝶显微切除垂体腺瘤具有适应证广、创伤小、手术全切率高、垂体功能保留好、并发症少等优点,是安全、有效、微创的治疗方法。

Microsurgery Through endonasal transsphenoidal approach for pituitary adenomas(a report of 63 cases)

Objective To summarize the experience in resecting pituitary adenomas by microsurgery through the endonasal transsphenoidal approach. Methods The clinical data of 63 patients with pituitary adenomas who underwent microsurgery through endonasal transsphenoidal approach from July, 2008 to June, 2010 were analyzed retrospectively, including the surgical indications, preoperative management, surgical technique, the prevention and treatment of postoperative complications and so on. Results Of 63 patients with piyuitary adenomas, 54 received total resection of the tumors and 8 subtotal. All the patients were followed up from 3 months to 3 years. The invasive pituitary adenoma recurred 2 years after the surgery in 1 patient. The vision improvement rate was 92.7% （38/41）, improvement rate of endocrine symptom was 88.0% （44/50）. No patients died during following up. Conclusions The microsurgery through endonasal transsphenoidal approach which is of merits including spread indication, little operation side-injury, high rate of total resection of the tumor, good protection of pituitary function and few complication is a safe and effective method to treat pituitary adenomas.