摘要
目的探讨鼻内窥镜在垂体腺瘤手术中的应用价值和适应证。方法开展了24例经鼻内窥镜垂体腺瘤切除手术。24例垂体腺瘤患者中20例为经鼻蝶窦进路,4例为经鼻中隔蝶窦进路。结果20例经鼻蝶窦进路瘤组织得到了完全切除,手术所需时间较经鼻中隔蝶窦进路显微外科手术明显缩短。4例经鼻中隔蝶窦进路中3例瘤组织完全切除,1例非分泌性腺瘤(Ⅴ期)患者因瘤组织侵犯鞍旁及海绵窦,仅行大部分切除。所有患者术后头痛、视力障碍和闭经泌乳等症状均有改善。16例次术前血清泌乳素(PRL)水平异常(23.0~125.0μg/L,平均64.9±43.7μg/L)的患者,术后血清PRL水平恢复正常。9例次术前血清生长激素(GH)水平异常(50.0~72.0μg/L,平均62.1±11.4μg/L)的患者,术后血清GH水平低于5.0μg/L。上述患者术后随访2~72个月(平均18±21个月)无复发。术后均未见颅内出血、视神经损伤、脑脊液鼻漏、脑膜炎及垂体功能低下等并发症。结论经鼻内窥镜垂体腺瘤切除术是一个简便、安全、有价值的外科技术,只要正确地掌握好此类手术的适应证,可以获得满意的治疗效果。
Objective To recognize the indications and the value of endoscopic transsphenoidal approach in surgical treatment of pituitany adenomas. Methods The management of pituitary adenomas in 24 patients was reviewed. Results Endoscopic transnasal transspheniodal approach was used successfully in 24 cases and endoscopic transseptal transsphenoidal approach was used successfully in 4 cases, total tumor resection in 23 cases and subtotal resection in 1 case were achieved. Conclusion This new technique offered a simple and rapid access to the sella turcica, and also, direct visualization which improve the surgeon′s ability to resect tumors, it is a safe, valuable and efficient procedure for removing pituitary adenomas. The indications and management of the complications of endoscopic pituitary surgery were discussed.
出处
《中华耳鼻咽喉科杂志》
CSCD
1998年第2期97-99,共3页
Chinese Journal of Otorhinolaryngology
关键词
内窥镜
垂体肿瘤
切除术
Endoscopy Pituitary neoplasms Sphenoid sinus