经单鼻孔蝶窦入路垂体瘤切除术并发症的防治

Complications of endonasal transsphenoidal ectomy of hypophyseoma prevention and cure

目的探讨单鼻孔经蝶入路显微手术治疗垂体瘤的并发症及其防治。方法对60例垂体瘤患者采用单鼻孔经蝶入路显微手术治疗,为预防及减少并发症的发生,术前选好适应证,术中精细操作,术后及时妥善处理并发症。结果60例垂体瘤手术均顺利,出血不多,并发症少,没有发生视力恶化、颈内动脉及其分支损伤、颅神经损伤、颅内感染、长期脑脊液漏等严重或永久性并发症。本组共发生各种类型的并发症15例,其中出现一过性尿崩症5例(8.3%),短暂脑脊液漏2例(3.3%),视觉障碍2例(3.3%),垂体功能低下2例(3.3%),低钠血症4例(6.6%),经积极治疗后均在3～8天内恢复。结论单鼻孔经蝶入路显微镜下切除垂体瘤并发症的发生与手术操作有关,熟悉局部解剖及良好的手术技巧可降低并发症的发生。术后并发症经积极合理的治疗能获得痊愈。

Objective To investigate prevention and cure of complications ofendonasal transsphenoidal ectomy of hypophyseoma. Methods sixty hypophyseoma patients were treated by endonasal transsphenoidal surgery with strict indication and fine operation to reduce complications. Results sixty patients＇ operations were successful, with few complications, such as deteriorating vision, internal carotid artery damage, injury of cranial nerve, intracranial infection and leakage ofcerebrospinal fluid, complications occurred in 15 patients, including 5 transient diabetes insipidus （8.3%）, 2 transient cerebrospinal fluid leakage （3.3%）, 2 impaired vision （3.3%）, 2 hypopituitarism （3.3%）, 4 hyponatremia（6.6%）. All patients recovered after active treatment in 3-8 days.Conclusions Complications are related with operative procedure ofmicroendonasal transsphenoidal surgery for hypophyseoma ; Familiar with local anatomy and mastering operation technique can reduce complications; All patients with complications can recover after active treatment.