经单鼻孔蝶窦入路显微切除垂体腺瘤（附54例报告）

目的探讨经单鼻孔蝶窦入路显微切除垂体瘤的手术方法及总结经验。方法回顾性分析经单鼻孔蝶窦入路显微手术切除54例垂体瘤患者的临床资料。结果肿瘤全切除48例,大部分切除6例。36例功能性腺瘤患者术后垂体激素水平31例恢复正常,其余5例亦有不同程度恢复。视力视野较术前均有不同程度改善,月经恢复3例,妊娠1例,无颅内感染及死亡病例。结论经单鼻孔蝶窦入路是治疗垂体瘤的一种有效、可靠的方法,具有切除彻底,麻醉和手术时间短,创伤小、风险小,术后恢复快,并发症少等优点。

Microsurgical resection of pituitary adenoma through endonasal transsphenoidal approach

Objective To explore the surgical technique of microsurgery through endonasal transsphenoidal approach and the experience of resection of pituitary adenoma.Methods The clinical data of 54 patients with pituiary adenoma treated by endonasal transsphenoidal microsurgery were analyzed retrospectively.Results Of the 54 patients with pituitary adenomas,48 underwent total resection and 6 subtotal.In the 36 patients with functional pituitary adenomas,the blood hormone level returned to normal in 21 and decreased more or less in 5 after the operation.All the patients differently improved in sight and visual field after the operation.The catamenia returned again in 3 patients and 1 patient was pregnant after the operation.No intracranial infection occurred and no patients died in all the patients.Conclusion The microsurgery through endonasal transsphenoidal approach,which ensures to complete resection with less trauma and fewer complications and the short duration of anaesthesia and surgery as well as quick restoration,is a reliable and effective method.