显微镜下经鼻蝶窦入路垂体瘤切除术的疗效分析

Endonasal-transsphenoidal microsurgical resection of pituitary adenoma

目的探讨经单鼻孔蝶窦入路显微手术切除垂体瘤的疗效。方法 2007年5月～2010年11月在该院住院的28例脑垂体瘤患者均采用显微镜下经单鼻孔蝶窦入路垂体瘤切除术治疗,对其临床资料进行回顾性分析。结果 28例患者中肿瘤全部切除20例,次全部切除8例,手术顺利,术后无死亡、颅内感染和视神经损伤发生。所有患者原有症状均明显缓解,视力障碍和视野缺损者术后均明显改善。8例泌乳素腺瘤患者术前和术后1周的血清泌乳素水平分别为(60.2±14.3)和(12.1±6.8)ng/mL,6例生长激素腺瘤患者术前和术后1周的血清生长激素水平分别为(27.6±5.2)和(8.6±4.0)ng/mL,手术前后比较差异均有显著性(P<0.05);其余激素水平手术前后无明显变化。结论经单鼻孔蝶窦入路显微手术切除垂体瘤是一种安全、有效的手术方法,值得临床推广应用。

[Objective] To investigate the efficacy of single-nostril transsphenoidal microsurgical resection of pituitary adenoma.[Methods] 28 patients with pituitary adenoma who hospitalized in our hospital from May 2007 to November 2010 all received single-nostril transsphenoidal microsurgical resection of pituitary adenoma and their clinical data were retrospectively analyzed.[Results] 20 patients underwent totally resection,8 patients underwent subtotally resection and all surgery went well with no postoperative deaths,infections and intracranial optic nerve injury occurred.The existing symptoms of all patients were significantly alleviate and visual impairment and visual field defects were significantly improved after operation.The serum prolactin levels of 15 cases with prolactinoma before and 1 week after surgery were（60.2±14.3） and（12.1±6.8） ng/mL respectively,the serum growth hormone levels of 6 cases with growth hormone adenoma before and 1 week after surgery were（27.6±5.2） and（8.6±4.0） ng/mL respectively,there were significant differences before and after surgery（P〈0.05）;while the other hormone levels before and after surgery had no significant change.[Conclusion] The single-nostril transsphenoidal microsurgical removal of pituitary adenoma is a safe and effective method and it is worthy of clinical application.