经单鼻孔蝶窦入路显微切除垂体腺瘤

Microsurgery through endonasal transsphenoidal approach for pituitary adenomas

目的探讨经单鼻孔蝶窦入路显微手术切除垂体腺瘤的治疗效果。方法分析经单鼻孔蝶窦入路显微手术切除垂体腺瘤的68例患者的临床资料。结果肿瘤全切除43例，次全切除11例，大部分切除14例。术前视力、视野障碍者62例中，术后改善61例，下降1例；术后出现一过性尿崩症20例；无脑脊液鼻漏。1例术后死于自发性蛛网膜下腔出血。术后随访3月～1．5年，头部MRI示肿瘤无残留47例，部分残留20例。结论经单鼻孔蝶窦入路显微切除垂体瘤近期效果满意。

Objective To explore the curative effects of the endonasal transsphenoidal microsurgery on the pituitary adenomas. Method The clinical data of 68 patients with pituitary adenomas who underwent microsurgery through the endonasal transsphenoidal approach from March, 20f 1, to June, 2012, were analyzed retrospectively. Results Total removal of the pituitary adenomas was reached in 43 patients, subtotal removal in 11 and partial in 14. The visual power and field were improved in 61 patients after the microsurgery, decreased in 1 and unchanged in 7 who had the normal visual power and field before the surgery. Transient diabetes insipidus occurred in 20 patients and there was not cerebrospinal fluid rhinorrhea in all the patients. One patient died of spontaneous subarachnoid hemorrhage after the microsurgery. Of 67 patients followed up from 3 months to 1.5 years, 20 had residual tumors shown by MRI and 47 not. Conclusion The recent curative effects of the endonasal transsphenoidal microsurgery on the pituitary adenomas are satisfactory.