经蝶窦鞍内手术严重和罕见并发症分析

目的 探讨经蝶窦鞍内手术严重和罕见并发症的原因和预防措施。方法 分析1962－2001年3月间200例经蝶窦鞍内手术，发生严重和罕见并发站的16例临床资料，探讨其发生原因与预防方法。结果 16例发生严重和罕见并发症（8％），其中死亡4例（4％），严重出血8例（4％），视力恶化2例（1％），精神障碍2例（1％），癫痫持续状态1例（0．5％），剧烈头痛1例（0．5％），脑组织损伤2例（1％）。结论 经蝶窦鞍手术与经颅手术相比损伤明显减少，但仍可发生多种并发症。严格掌握手术适应证、术前细胞阅读CT片、熟悉鞍区解剖、熟练掌握经蝶手术技术会明显减少经蝶鞍内手术并发症。

Analysis of sever and rare complications of transsphenoidal surgery for lesions of sella turcica]

OBJECTIVE: To analysis the reason and prevention of sever and rare complications of transsphenoidal surgery for lesions of sella turcica. METHODS: The clinical data of 16 cases who occurred sever and rare complications during transsphenoidal surgery for 200 cases of lesions of sella turcica was analyzed. The reason and prophylaxis of complications was inquired. RESULTS: The sever and rare complications occurred in 16 cases. 4 cases died and 8 cases bleed severly and the version of 2 cases was deteriorated and 2 cases had mental disorder and 2 cases had epilepticism and 1 cases had sever postoperative headache and the brain was damaged in 2 cases among 16 cases. CONCLUSION: Although the transsphenoidal surgery comparing with transcranial surgery has mini-invasive, many complications can occur and can be decreased by selecting surgical accommodation strictly and similarity with anatomy of sella turcica and mastering transsphenoidal surgical technique skilled.