单鼻孔经鼻蝶鞍垂体瘤切除术疗效观察及并发症处理

Effects and complications of microscopic endonasal transsphenoidal surgery for pituitary tumors

目的:探讨单鼻孔经鼻蝶鞍垂体瘤切除术的手术方式、治疗效果及并发症处理。方法:对郑州大学第一附属医院神经外科2006年6月至2012年4月手术治疗的126例单鼻孔经鼻蝶垂体瘤切除术病人进行回顾性分析,观察其临床疗效和术后并发症。结果:全切除89例(70.63%),次全切31例(24.60%),部分切除6例(4.76%)。术后症状改善或消失者118例(93.65%)。术后出现尿崩30例,水电解质紊乱91例,脑脊液鼻漏31例,并发感染12例,高热26例,垂体功能低下8例。术后并发症经对症处理可消失,极少垂体功能低下者需长期补充激素。结论:单鼻孔经鼻蝶垂体瘤切除术手术耗时少,手术创伤小,手术效果好。术后并发症的处理是判断预后的关键因素。

Objective： To explore the methods and surgery treatment effects and complications of microscopic endonasal transsphenoidal surgery for pituitary tumors.Methods： 126 cases of microscopic endonasal transsphenoidal surgery for pituitary tumors in department of neurosurgery of First Affiliated Hospital of Zhengzhou University from June 2006 to April 2012 were retrospectively analyzed to observe the clinical efficacy and postoperative complications.Results： Total removal in 89 cases（70.63%）,31 cases（24.60%） of subtotal and partial resection of 6 cases（4.76%）.The symptoms improved or disappeared after operation in 118 cases（93.65%）.After operation,diabetes insipidus appears in 30 cases,water and electrolyte disturbance in 91 cases,cerebrospinal fluid rhinorrhea in 31cases,12 cases of concurrent infections,26 cases of high fever,hypopituitarism in 8 cases.Postoperative complications disappear after symptomatic treatment and rarely hypopituitarism cases need long-term supplemental hormones.Conclusion： The method of microscopic endonasal transsphenoidal surgery for pituitary tumors is less time-consuming,less surgical trauma and good effect.The treatment of postoperative complications is a key factor of prognosis.