CO_2激光显微技术治疗蝶鞍区肿瘤

CO_2 laser-microscopy technique in treating tumors near the sella turcica

目的 探讨激光显微技术在切除鞍区肿瘤中的应用。 方法 对 1995年 10月至 1998年 6月应用激光显微技术治疗的 16例鞍区肿瘤患者进行分析。 结果 16例患者肿瘤全切除 11例 ,次全切除 5例 ,随访 4～ 30个月 ,效果良好。术前 9例视力、视野改变者有 6例得到明显改善 ,2例好转 ,1例变化不显著。内分泌改变的 6例中有 4例恢复正常 ,2例改善 ,有 4例颅内压增高者 ,术后症状均已解除 ,术后有 1例发生尿崩 ,经药物治疗 2周后痊愈。 结论 激光显微技术应用于蝶鞍区肿瘤切除有以下优点 :(1)精确度高 ,误伤少。 (2 )减少机械操作 ,对下丘脑、垂体柄等侵扰少 ,术后反应小。 (3)对术野暴露范围要求相对不大。 (4)止血效果良好 ,术野清晰。 (5 )对性质不良的肿瘤没有促使肿瘤转移的危险。 (6 )没有生物电干扰 ,不影响术中监护设备的应用。

Objective[WT5”BZ] To assess the laser microscopy technique in deating with tumors near the sella turcica. [WT5”HZ]Methods[WT5”BZ] Sixteen patients with tumors near the sella turcica who had been treated surgically by laser microscopy technique from October 1996 to June 1998 in Haikou municipal hospital were analyzed retrospectively. [WT5”HZ]Results[WT5”BZ] In these patients, 11 patients had tumors bodies excised totally, and 5 had tumors bodies excised partially. All of then were followed up for 4 to 30 months. The curative effects were satisfactory. In 9 patients with defect in vision before operation, 6 showed obvious improvement, 2 moderate improvement, and 1 unmarked improvement. In 6 patients with endocrinepathy before operation, 4 returned to normal, and 2 showed improvement. In 4 patients with intracranial hypertension before operation, symptoms were retieved. Only one patient who had diabetes insipidus after operation, and recovered after medication. [WT5”HZ]Conclusions[WT5”BZ] CO 2 laser microscopy technique the treatment of tumors near the sella turcica is advantageous: few accidental injuries because of its high accuracy; less harassment to the hypophysis and subthalamus; less complication; small exposure of operative field; less bleeding and clear operative field; no stimulation of metastasis of carcinoma;and no interference of bioelectric current. [WT5”HZ]