大型垂体瘤不同手术入路治疗的比较研究

Comparative Study of Different Operative Approach for large Pituitary Adenomas

本文回顾性比较106例大型垂体瘤的开颅和经蝶手术治疗的比较。开颅组58例,经蝶组48例。开颅组肿瘤次全切除9例,大部切除48例,部分切除1例;经蝶组全切除35例,大部切除12例,部分切除1例。开颅组术后视力好转率71%,无变化12例,恶化3例。手术后偏盲好转率67%;经蝶组手术后视力好转率77%,无变化者11例,无1例恶化。手术后偏盲好转率93%。开颅组20例有额叶挫伤,其中1例并发脑内血肿,死亡4例。作者认为垂体腺瘤不长向鞍旁、海绵窦、前颅窝底和脚间池和肿瘤不呈瓶颈样生长者,都应优先考虑经蝶窦入路手术。

106 Cases with large pituitary adenomas were treated by transcranial and transsphenoidal approach respectively.The former had 58 cases,the latter had 48 cases.of both group cases age,sex,size of tumors and visual disturbance were similar.postoperatively vision and hemianopsia progress in 71% and 67% of transcranial group,and in 77% and 93% of transsphenoidal group. 5 cases of hemianopsia had recovered completely. In transcranial group,frontal contussion had 20 cases,one case complic- ated intracerebral hematoma,4 cases died of hypothalamus and carotid ar- tery damage;in transsphenoidal group,CSF rhinorrhea had 2 cases.