垂体肿瘤的显微外科治疗

目的 分析和探讨垂体腺显微手术方法的选择。探索安全有效的治疗手段。方法 对经CT或MRI证实的34例垂体腺瘤；采用经蝶入路或经颅入路两种手术方法，在显微镜下切除肿瘤。结果 经蝶手术14例。全切除11例，次全切除3例。无一例死亡；经额手术20例，全切除9例，次全切除7例，部分切除4例，死亡1例（死于多器官功能衰竭）。本组有9例（26.5%)术后出现并发症，经蝶手术后最常见的并发症为脑脊液鼻漏；经颅手术后最常见的是尿崩症。结论 在手术方式的选择上，我们认为需结合临床和影像学检查综合分析，决定手术对策；其中神经放射学所提供的影像资料具有及其重要的价值。采用显微外科手术切除垂体腺瘤是安全，有效的方法。

The study of microsurgery treatment for pituitary adenoma

Objective To explore the methods of microsurgery and find a ideal surgical approach fo pituitary adenomas. Methods The 34 patients were treated microsurgically either with transsephenoidal or transcranail approach that was confirmed by CT or/and MRI scan. Results The transsephenoidal approach was performed in 14 patients, the gross total removal of adenoma in 11 cases and subtotal removal in 3 cases. There was no operative death in this group.The transcrainal approach was done in 20 patients including the gross total removal of adenoma in 9 cases, subtotal removal in 7 cases and partial removal in 4 cases, only one patient was dead. There were complications in 9 patients. The cerebrospinal fluid rhinorrhea usually ocured in the patients treated by transsephenoidal. The diabetes insipidus usually ocured in the patients treated by transcranial. Conclusion Microsurgical technique is a safe and effective way to remove the pituitary adenomas.