经蝶和经额底入路显微切除大型、巨大型垂体腺瘤

目的：通过对28例大和巨大型垂体腺瘤采用不同入路的手术治疗结果进行分析，探讨较理想的治疗原则。方法：28例分经蝶组及经额组各15、13例。经蝶组采用经唇下蝶窦入路显微镜下肿瘤切除术，术中配合PEEP使鞍上部分肿瘤塌陷达到完整切除。经额组采用经额底入路显微镜下肿瘤切除术。结果：28例肿瘤中，手术全切经蝶组为11例，经额组为10例，只行大部切除经蝶组3例，经额组4例，原因均为肿瘤侵袭人鞍膈上及海绵窦内无法全切。结论：经蝶入路手术创伤小，患反应轻，并发症少，有广泛应用的前景。

Resecting the big or great pituitory adenoma by sublabial transsphenoidal approach or transfrontal basal approach under the microscope

Objective:Through analysing the result of 26 cases with big or great pituitory adenoma operated by different approach,to explore the ideal principle of treatment.Methods:28 cases were divided into sublabial tanssphenoidal group(15 cases,group A)and transfrontal group(13 cases,group B).The group A adopted sublabial tanssphenoidal approach to resect the tumor under the microscope,the tumor over the diaphragma sellae can be completely resected by using PEEP intraoperation.The other group adopted transfrontal basal approach.Results:Among 28 cases,11 cases in group A and 10 cases in group B were completely resected,3 cases in group A and 4 cases in group B were only partly resected,the reason was the tumor invading the diaphragma sellae and cavemous sinus.Conclusion:The microsurgery by sublabial transsphenoidal approach has the features of few lesions and complications and slight response after operation and safety,and would be extensively adopted.