巨大垂体瘤的经鼻蝶窦进路显微切除术

Microsurgery of Large Pituitary Adenoma Via Transnasal Sphenoid Approach

目的:总结经蝶窦进路显微手术治疗巨大垂体瘤的经验。方法:经蝶窦进路显微手术治疗直径在30mm以上的巨大垂体瘤58例。结果:58例中,镜下全切除者52例、大部分切除者6例,经手术治疗后症状均有不同程度的改善。1例于术后1个月死于垂体危象。余57例患者术后随访2～5a,复发5例均经再次手术治愈。结论:巨大垂体腺瘤的手术治疗仍以经蝶窦进路为首选。

Objective： To summarize experience of microsurgery of large pituitary adenoma via transnasal sphenoid approach. Methods： 5.8 cases of large pituitary adenoma, whose diameter exceeded 30 ram, received microsurgel7 via sphenoid sinus approach. Results： Among the 58 cases, total resection was completed in 52 and mnity partial resection in 6. These patients＇ clinical symptoms were improved in various degrees after operations. One case died of pituitary efnergency one month after operation. 57 cases were followed up for 2 - 5 years. 5 cases recurrent were cured by the second operation. Conclusion ： The preferential choice for treatment of large pituitary adenoma is tumorectomy by sinus sphenoidalis approach.