巨大型垂体腺瘤51例报告

Report of 51 cases with giant pituitary adenoma

目的总结经单鼻孔-蝶窦入路和经额下入路显微手术治疗巨大型垂体腺瘤的临床经验。方法显微手术治疗巨大型垂体腺瘤51例，其中经单鼻孔-蝶窦入路手术13例，经额下入路手术38例。结果经单鼻孔-蝶窦入路显微手术全切7例，大部切除4例，部分切除2例；经额下入路显微手术全切18例，大部切除13例，部分切除4例，死亡3例。两种手术方法的疗效无明显差别。结论经单鼻孔-蝶窦入路和经额下入路显微手术都是治疗巨大型垂体腺瘤的有效方法，术后正确选用溴隐亭和伽玛刀治疗可提高巨大型垂体腺瘤的治愈率。

Objective To summarize the experience of microsurgical operation via single nostril-sphenoid sinus approach or via subfrontal approach on giant pituitary adenoma. Methods Microsurgical operations were performed on 51 cases of giant pituitary adenoma via single nostril-sphenoid sinus approach （n=13） or via subffontal approach （n=38）. Results Total resection was achieved in 18 cases by the operation via subffontal approach, most resection in 13 cases, partial resection in 4 cases,postoperative death in 3 cases. Another a few patients were operated via single nostril-sphenoid sinus approach, in which total resection was executed in 7 cases, most resection in 4 cases, partial resection in 2 cases. The statistical differences in the total removal rate and curative effect were meaningless between the two groups. Conclusion The giant pituitary adenoma can be treated by microsurgical operation via single nostril-sphenoid sinus approach or via subfrontal approach. The cure rate of giant pituitary adenoma can be increased by postoperative treatments with bromocriptine and γ-knife.