神经导航辅助下经鼻蝶入路垂体瘤切除术及手术配合

Pituitary adenomas resection with neuronavigator-assisted endonasal transsphenoidal approach and cooperative nursing

目的探讨神经导航在经鼻蝶垂体瘤切除术中的应用及护理配合技术。方法应用导航技术经鼻蝶窦切除49例垂体腺瘤。术前行三维重建,确定手术入路,术中实时导航,监测肿瘤切除程度。做好患者心理护理,掌握神经导航仪的操作方法,备齐术中所需器械、物品和药物,熟悉手术配合过程,术中严格无菌操作。结果49例患者全切38例,次全切11例,术后原有症状均有明显改善,无严重并发症发生,均痊愈出院。结论神经导航辅助下经鼻蝶垂体瘤切除术是一种定位准、损伤小、反应轻、疗效好的微创手术,高质量的手术配合是手术成功的重要保证。

Objective To explore the application of neuronavigation system to pituitary adenomas surgery through endonasal transsphenoidal approach and the cooperative nursing technology. Methods Forty - nine cases underwent surgical treatment through endonasal transsphenoidal approach. The data of cases were integrated before operation and real - time guided operational procedure was monitored by neuronavigation system. The nurses implemented mental care for patients and mastered operation of neuronavigation. Meanwhile, the nurses prepared the appliances, objects and drugs needed in hypophysectomy, cooperated with the operation process and obeyed sterile principles strictly. Results Pituitary adeno- mas in 49 cases were accurately located. Gross - total resection was achieved in 38 cases and subtotal resection in 11 cases. All of them were recov- ered. Conclusion The application of neuronavigution to the endonasal transsphenoidal surgery is microsurgery with less injury, accurate location, slight reaction and good effect. High quality of nursing is important for the success of the surgery.