47例经蝶窦入路垂体巨大腺瘤手术并发症分析

Complication analysis of 47 cases undergoing giant pituitary adenomas surgery via transsphenoidal approach

目的分析及讨论显微镜下经单鼻孔-蝶窦入路切除垂体巨大腺瘤的并发症的特点。方法对我院2007年1月～2011年12月收治的47例经单鼻孔-蝶窦入路切除巨大垂体腺瘤患者的并发症情况进行回顾性分析。结果术后出现甲状腺激素下降12例,皮质醇激素下降9例,尿崩症8例,继发出血3例,脑脊液鼻漏1例,嗅觉一过性丧失1例。结论经单鼻孔-蝶窦入路切除垂体巨大腺瘤效果显著,熟悉局部解剖,熟练掌握手术技能,全面掌握患者术前情况,关注手术环节,不断总结经验可有效避免手术并发症的出现。

Objective To analyze and discuss characteristics of complications in microsurgical resection of giant pituitary adenomas via single nostril-transsphenoidal approach. Methods Complications of 47 patients admitted from January 2007 to December 2011 undergoing giant pituitary adenomas surgery via single nostril-transsphenoidal approach were analyzed retrospectively. Results After the surgeries, some patients occurred complications like 12 cases with thyroid hormone decline, 9 cases with reduced hormone cortisol, 8 cases with diabetes insipidus, 3 cases with secondary hemorrhage, 1 case with ccrebrospinal fluid rhinorrhea, and 1 case with temporary smell loss. Conclusion Resection of giant pituitary adenomas via single nostril-transsphenoidal approach has its remarkable clinical effect. Physicians should be familiar with local dissection, proficiently master surgical skills, comprehensively grasp preoperative conditions of patients, focus on operation process, and constantly sum up experience, then they can effectively avoid the occurrence of surgical complications.