神经内镜下单鼻孔经蝶窦入路垂体瘤切除手术的临床体会

目的 探讨神经内镜下单鼻孔经蝶窦入路垂体瘤切除的手术方法及疗效。方法 2011 年3 月至2013年6 月收治的垂体瘤患者共53 例，均行神经内镜下单鼻孔经蝶窦入路垂体瘤切除手术，对患者的手术效果、术后并发症、住院天数等指标进行回顾性分析。结果 神经内镜下单鼻孔经蝶窦入路垂体瘤完全切除49 例（92.4%），次全切除4 例（7.6%），术后平均住院天数6.2d，无手术死亡病例。术后出现并发症5 例（9.4%），1 例患者术后出现鞍内出血及额叶血肿，1 例患者麻醉清醒后视力下降，2例出现一过性尿崩，1例出现脑脊液漏。结论 神经内镜下单鼻孔经蝶窦入路垂体瘤手术具有创伤小、术后并发症少及恢复快等优点，是治疗垂体瘤较为有效的术式。

Neuro-endoscopic endonasal transsphenoidal surgery for pituitary adenomas: a clinical analysis

Objective To review the surgical procedure and effect of endoscopic endonasal transsphenoidal approach for resection of pituitary adenomas. Methods Clinical data of 53 cases of pituitary adenomas undergoing tumor resection with endoscopic endonasal transpterygoid approach(EETA) were retrospectively reviewed. The surgical effect, postoperative complications,hospitalization days were analyzed. Results The tumors were totally removed in 49 (92.4%) cases and subtotally removedin 4 (7.6%). The average postoperative hospital stay was 6.2d, with no surgery related deaths There were concurrent saddle hematoma and frontal lobe hematoma after operation in 1 case, vision loss after anesthesia in 1 case, diabetes insipidus in 2 cases,cerebral spinal fluid leak in 1 case with a postoperative complication rate of 9.4% . Conclusion Endoscopic endonasal transsphenoidal approach is a minimal invasive approach for resection of pituitary adenomas with less postoperative complication.