经单鼻孔垂体瘤手术并发症

Complications of microsurgery via single-side nostril-sphenoidal for pituitary adenoma

目的:分析经蝶入路切除垂体腺瘤的手术并发症。方法:回顾性分析2001年1月～2009年12月我科696例经蝶手术的垂体腺瘤病人术后并发症。结果:尿崩症发生率为56.6%,低钠血症3.1%,视力恶化0.3%,垂体功能低下1.6%,中枢神经损伤0.3%,眼肌麻痹0.6%,脑脊液鼻漏4.5%,颈动脉损伤0.1%,残瘤出血或肿胀0.3%,脑膜炎0.1%,垂体脓肿0.1%,病死率0.3%。结论:熟悉手术局部解剖,把握手术适应证,熟练掌握手术技能、不断总结临床实践经验,才能降低手术并发症和病死率,提高治疗效果。

Objective：To analyze the complications of transsphenoidal operation for pituitary adenomas.Methods：Postoperative complications of 696 patients underwent transphenoidal surgery for pituitary adenoma between January 2001 and December 2009 in our department were retrospectively reviewed.Results：Insipidus was the most common complication after the operation with the incidence of 56.6%,hyponatremia was the second one with the incidence of 3.1%.The other significant complications were visual deterioration 0.3%,anterior pituitary insufficiency 1.6%,central nervous system injury 0.3%,ophthalmoplegia 0.6%,cerebrospinal fluid rhinorrhea 4.5%,carotid artery injuries 0.1%,hemorrhage or swelling of residual tumor 0.3%,meningitis 0.1%,pituitary abscess 0.1%.The case fatality rate was 0.3%.Conclusion：Better understanding of the indications for transsphenoidal surgery and familiarity with the regional anatomy should further lower the rates of death and complications.Skill surgical technique and clinical experience are also very important to improve the therapeutic efficacy.