儿童与青春期垂体腺癌经蝶显微手术治疗

经蝶显微手术是作为儿童与青春期垂体腺瘤患者的一种治疗手段．方法：回顾性总结28例儿童与青春期垂体腺瘤的诊断方式、手术技巧和治疗结果．女15、男13例，年龄8～18岁，平均14．6岁．其中大腺癌10例，微腺瘤18例．本组均经血清激素检查、CT或MRI扫描确诊．手术采取经唇下－鼻中隔－蝶窦入路或经鼻前庭－鼻中隔－蝶窦入路两种方式行肿瘤切除术．结果：术后无死亡．23例获长期随访（平均2．5年），有19例（82．6％）恢复良好；4例（17．4％）血清激素水平又有增高，且影像学检查提示肿瘤有复发，需行再次手术或药物治疗．结论：儿童与青春期垂体腺瘤经蝶入路显微手术切除是一种安全、有效的方法．

Transsphenoidal microsurgical treatment of pituitary adenomas in childhood and adolescence

Transsphenoidal microsurgery is a method of the treatment for patients with pituitary adenoma in childhood and adolescence. Methods: We review the diagnostic modes, surgical technique, and outcome of 28 patients with pituitary adenoma in our department between July 1985 and July 1996. There were 15 females and 13 males. The patients ranged in age from 8 to 18 years with a mean of 14. 6 years. Of the patients,10 (35. 7 % ) were macroadenomas and 18 (64. 3 % ) were microadenomas. Diagnosis was made by serum hormone level detection, CT or MRI scan. operations were performed via either sublabio-septo-sphenoidal approach or naso-vestibulo-sphenoidal approach. Results: There were no deaths after operation in this patient group.Long-term follow-up review (mean: 2. 5 years) in 23 patients revealed good recovery in 19 patients (82. 6% ),and recurrence in 4 patients (17. 4 % ), for whom, further operative management or drug therapy was needed.Conclusion: It is safe and effective to remove pituitary microadenoma by using the microsurgical technique via transsphenoidal approach