经蝶窦入路垂体瘤切除的麻醉处理

本文总结212例蝶窦入路垂体瘤切除术的麻醉处理。其中泌乳素瘤125例,生长激素瘤58例,促肾上腺皮质激素(ACTH)垂体瘤10例,非分泌性肿瘤19例。术前部分病例并存有高血压、心电图异常、糖尿病、甲状腺机能亢进、电解质异常和尿崩症,以 ACTH 瘤和生长激素瘤并存症的比例最高。作者认为术前应注意患者内分泌状况,尤其是肾上腺皮质和甲状腺功能。对 ACTH 瘤和生长激素瘤者,术前、术中控制血糖、血压和血电解质改变至为重要。对肢端肥大症患者的气管插管难度应有充分的准备和判断。

Anesthetic management of surgery for pituitary adenoma by transphenoidal approach

This report summarized the anesthetic management of 212 patients with pituitary adenoma operated through transphenoidal approach of these patients,125 cases had prolactinoma,58 cases had GH-producing tumor,10 cases had ACTH-secreting tumor,19 cases had non-seeretional adenoma. Before operation,some patients were accompanied by such complications as hypertension,abnormal ECG,diabetes,hyperthyroidism,abnormal electrolyte and diabetes insipidus,which were most frequent in cases with GH and ACTH-secreting tumors.We think that preoperational attention must be paid to the endocrine status of the patients,especially to the adrenocortical and thyroid function.It is important to manage the blood glucose,hypertension and changes of electrolyte in preoperation and during operation for the patients with ACTH and GH-secrecting tumor.Preparation and right recognition must be made for the difficult intubation during anesthesia for the patients with acromegaly.