经鼻蝶入路手术治疗垂体腺瘤112例术后并发症因素分析

目的:探讨经鼻蝶入路垂体腺瘤切除术的手术及术后并发症。方法:对112例垂体瘤患者行经单鼻孔鼻蝶入路垂体腺瘤切除术,并分析其疗效及并发症发生的相关因素。结果:肿瘤全切除97例(占86.6%),次全切除15例(占13.4%)。术后出现并发症患者29例(占25.9%);其中出现尿崩症状12例(占10.7%);垂体功能低下5例(占4.5%);脑脊液鼻漏4例(占3.6%);视力减退2例(占1.8%);中枢性高热2例(占1.8%);外展神经麻痹1例;2例患者术后出现鼻腔内出血,1例继发颅内感染死亡。结论:经鼻蝶入路切除垂体腺瘤手术疗效确切,安全性高。术后并发症以尿崩症、垂体功能低下较常见,术中规范、轻柔的手术操作,围手术期的处理等对减少术后并发症有重要意义。

Clinical analysis after transspheniodal ectomy of pituitary adeno mas:effects and complications

Objective： To analyze the effects and complications of transsphenoidal surgery for pituitary adenomas. Methods： The clinical data of 112 cases underwent surgery for transsphenoidal pituitary adenomas were analyzed retrospectively. Results ：Total resection was performed in 97 cases （86. 6%） and subtotal resection in 15 cases （13.4%）. The postoperative complications were occurred in 29 cases （25.9 %）, which were diabetes insipidus in 12 cases （10. 7%）, hypopituitaism in 5 cases （4. 5%）, cerebrospinal fluid leakage in 12 cases （10. 7%）, visual extinction in 2 cases （1. 8%）, central high fever in 2 cases （1. 8%）, abducens nerve paralysis in one case, blooding in nasal cavity in 2 cases, intracranial infection in one case. Conclusion： Transsphenoidal surgery for pituitary adenomas is effective and safe. Diabetes insipidus and hypofunction of anterior pituitary are the most frequent postoperative complications in patients. It is important to conduct normal, gentle operation and adequate management during operation for decreasing postoperative complications.