手术显微镜下经单鼻孔蝶窦入路切除垂体腺瘤

Single-nostril transsphenoidal microsurgery for pituitary adenoma

目的总结经单鼻孔蝶窦入路垂体腺瘤手术治疗体会。方法手术显微镜下经单鼻孔蝶窦入路手术治疗垂体腺瘤52例。术中将鼻镜直接置于蝶窦前壁,将筛骨垂直板连同骨性鼻中隔一起向对侧推开,凿开蝶窦前壁骨质,进入蝶窦,打开鞍底,切除肿瘤。结果全切除31例,次全切除14,部分切除7例。术后并发症轻,无重症及死亡病例发生,手术效果较满意。结论经单鼻孔蝶窦入路是大部分垂体腺瘤手术首选,手术操作直接影响预后。准确把握手术适应症、术前仔细阅片,术中精确定位、精细操作加必要的手术技巧是成功的法宝。

Objective To summarize the one-nostril transsphenoidal surgical treatment of pituitary adenomas.Methods 52 patients with pituitary adenoma were treated with surgical microscope endonasal transsphenoidal approach.Rhinoscopy was directly placed on sphenoid anterior.The perpendicular plate of the ethmoid bone with the nasal septum was pushed to the opposite side.The saddle bottom was opened and the tumor was removed.Results There were 31 patients with total resection,14 patients with subtotal resectIon and 7 patients with partial resection.Non-severe complications and deaths have occurred.Conclusion The single-nostril transsphenoidal pituitary adenoma surgery is the most preferred,the operation directly affect the prognosis.Accurately grasp the surgical indications,preoperative careful reading films,intraoperative accurate positioning,fine operation plus the necessary surgical skills to be successful magic weapon.