神经内镜下双鼻孔入路垂体腺瘤切除术临床分析

Surgical treatment for pituitary adenoma by neuroendoscopic bilateral endonasal transsphenoid approach:a clinical analysis

目的总结分析内镜下双鼻孔经蝶入路垂体腺瘤切除术的经验和体会。方法回顾性分析60例内镜下双鼻孔经蝶入路垂体瘤切除术患者的临床资料,分析总结其疗效、并发症,总结该方法的优越性。结果 53例(88.3%)全切,6例(10.0%)次全切,1例(1.7%)部分切除。所有病例随访6～24个月,39例头痛症状明显缓解;27例视力、视野明显改善。术前泌乳素增高的26例中,16例术后降至正常,7例降低50%以上;生长激素增高的15例中,11例术后降至正常,2例降低50%以上。结论内镜下双鼻孔经蝶窦入路垂体腺瘤切除术,能够在有效的切除肿瘤组织,提高了切除率,降低了并发症的发生,临床应用前景好。

Objective To summarize the treatment experience of pituitary adenoma resection by bilateral endonasal transsphenoidal approach under neuroendoscopy. Methods A total of 60 patients with pituitary adenoma were treated by neuroendoscopic bilateral endonasal transsphenoid surgery. Clinical data were analyzed retrospectively. Results The post-operative MRI revealed that the tumor was totally removed in 53 （88. 3% ） cases, subtotally in 6 （ 10. 0% ）, and partially in 1 （ 1.7% ）. All patients were followed up for 6 - 24 months. Headache disappeared in 39 patients. The vision and field were improved in 27 patients. Among the 25 patients with increased prolactin hormone, 16 recovered to normal hormone level after operation, and 7 cases reduced by more than 50% ; among 15 patients with increased growth hormone, 11 recovered to normal and 2 reduced by more than 50%. Conclusion The surgical treatment of pituitary adenoma by neuroendoscopic bilateral endonasal transsphenoid approach is satisfactory in tumor resection and reducing complications, with a good prospect in clinical practices.