巨大垂体腺瘤的显微手术治疗

目的探讨巨大垂体腺瘤显微手术治疗经验.方法采用改良翼点入路对48例巨大垂体腺瘤行显微手术治疗.结果肿瘤全切除36例,近全切除8例,大部全切除4例,其中全切除患者垂体柄保留30例.术后发生尿崩症者31例,其中21例在1～2周内恢复正常,7例在3个月内恢复,3例尿崩症持续1年左右.结论采用改良翼点入路治疗巨大垂体瘤效果确切.术中垂体柄保留是降低术后尿崩症、提高手术疗效的关键措施.

Experience of microsurgical operation in total removal of gaint pituitary adenoma

Objective To introduce the microsurgical operative experience of giant pituitary adenoma. Methods 48 cases were treated by modified transpterional approach. Results Total removal of the tumor were got in 36 cases,among which the pituitary stalk were reserved in 30 cases. Of all cases subtotal removal were got in 8 cases, and greater part removal in 4 cases without dead patients. After the operation 31 cases suffered from diabetes insipidus,among which 21 cases recoved in one to two weeks after apteration,7 cases recovered in three months. Diabetes insipidus continued for one year or so in 3 cases. Condusions Modified pterional approach is the best one in the micosurgical removal of giant pituitary adenomas and it is the key to reduce the incidence of postoperative diabetes insipidus and improve the therapeutic effects reserving the pituitary stalk during operation.