单鼻孔蝶窦入路显微手术治疗垂体腺瘤25例临床分析

Treatment of 25 patients with pituitary adenomas by microsurgery through endonasal transsphenoidal approach

目的总结25例经单鼻孔蝶窦入路切除垂体腺瘤的疗效,探讨手术技巧和经验。方法对25例采用该入路手术治疗的垂体腺瘤病人临床资料进行回顾分析。结果 25例患者中肿瘤全切除14例,大部分切除8例,部分切除3例。18例功能性垂体腺瘤,14例患者术后垂体激素水平恢复正常,其余4例有不同程度恢复。视力、视野较术前有不同程度改善,月经恢复11例,术后一过性尿崩症9例,脑脊液鼻漏1例,无死亡病例。结论经单鼻孔蝶窦入路显微手术切除垂体腺瘤是一种安全、有效的方法,手术损伤小,并发症少,术后恢复快,可作为绝大多数垂体腺瘤患者首选治疗方法。

Objective To summarize the curative effect of 25 patients whth pituitary adenomas through endonasal transsphenoidal approach and to explore the surgical technique and the experiences of microsurgery.Methods The clinical data of 25 patients whose puituitary adenomas were resected by microsurgery through this approach were analyzed retrospectively.Results Of the 25 cases of pituitary adenomas treated by microsurgeny throngh the endonasal transsphenoidal approach,14 were totally resected,8 subtotally and 3 partially.In 18 patients with functional pituitary adenomas,the blood hormone level returned normal in 14 and decreased more or less in 4 after operation.All the patients were differently improved in sight and visual fieold after rhe operation.The catamenia appeared again in 11 patients.There was temporal diabetes insipidus in 9 patients and cerebrospinal fuild rhinorrhea in 1.No patients died of the operation.Conclusion Endonasal transsphenoidal approach is a sound and safe microsurgery for treating pituitary adenomas effectively.This approach has advantages such as mimimal invasine,few complications and quick restoration to patients health,it should be first selected in the patients whth pituitary adenoma.