显微镜下单鼻孔经蝶窦垂体瘤手术切除技巧的研究

Microscope Order Nostril Transsphenoidal Pituitary Tumor Surgery Techniques Research

目的:探讨显微镜下单鼻孔经蝶窦入路手术技巧对治疗巨大垂体腺瘤的临床意义。方法:回顾性分析2006-2012年手术治疗垂体腺瘤患者87例,根据治疗方法的改进,患者分为两组:2006-2009年组应用常规的经鼻蝶垂体瘤手术方式;2010-2012年组采用扩大蝶窦及鞍底,切除过程中逐层刮除及适度负压吸引技术。两组患者手术前后均进行鞍区冠状CT、MRI检查,并行内分泌学检查。结果:2006-2009年组肿瘤全切16例,次全切除18例,部分切除6例。2010-2012年组肿瘤全切31例,次全切除15例,部分切除1例。两组数据对比,差异有统计学意义(P<0.05)。结论:扩大蝶窦及鞍底,以及在切除肿瘤过程中逐层刮除、适度负压吸引技术对于增加垂体瘤的切除率,减少手术并发症有重要作用。

Objective： To explore the clinical effects of microscopic endonasal transsphenoidal approach in treatment of giant pituitary adenoma. Method： 87 cases of pituitary adenoma with surgical treatment from 2006 to 2012 were retrospective analysised. The patients were divided into two groups according to different treatment methods： the year 2006 to 2009 group with routine endonasal transsphenoidal approach, the year 2010 to 2012 group with expanded sphenoid sinus and saddle bottom, step by step removing and moderate negative pressure suction technique. Preoperative and postoperative saddle area coronary CT, MRI scanning and endocrinology inspection were performed between the two groups. Result： In the year 2006-2009 group, 16 cases were totally removed, 18 cases were subtotally removed and 6 cases were partial removed. While in the year 2010-2012 group 31 cases were totally removed, 15 cases were subtotally removed and only 1 case were partial removed. There was statistical significance between the two groups （P〈0.05） . Condusion： Expanded sphenoid sinus and saddle bottom, step by step removing and moqerate negative pressure suction technique can increase resection rates of pituitary adenoma and reduce the complications.