大型垂体腺瘤“经颅、经眶(经筛)、经蝶入路”的手术研究

A New Operative Approach to Transcranial,Orbital,Ethmoid and Sphenoid Sinus for Large Pituitary Adenoma

对２５例大型垂体腺瘤采用经颅、经眶（经筛）及经蝶扩大切除骨瓣入路的新显微手术方法．结果：肿瘤全切者１６例（６４．０％），次全切者７例（２８％），部分切除者２例（８％）．本组病例术后常规给予放射治疗，临床症状与内分泌功能于术后复查均恢复至正常范围或明显改善，经过１～５．５年追踪尚未见复发者．此术式将经颅与经蝶两种入路于鞍结节处融合成一个大术野，扩大了手术视野，缩短了手术入路，有利于显微手术切除大型垂体腺瘤，提高了全切率．

A new microsurgical approach to transcranial,orbital,ethmoid and sphenoid sinus in 25 cases of large pituitary adenoma were put forward.The results showed that a total removal of the tumor in 16 cases (64%),subtotal removal in 7 cases (28%),partial removal in 2 cases (8%).Routine radiotherapy was given in this series.After the operation,the clinical symptoms and endosecretory function became normal or very much improved.In a follow up of 1～5.5 years,there was no recurrence in these cases.This method combined with traditional transcraniol and transsphenoid approaches at the tubercular sellar to form one operation,which provide the wide exposure and the shorter distance.It was helpful to perform microsurgery for large pituitary adenoma,and increase the rate of tatal removal.