垂体腺瘤显微手术中垂体柄的保护与术后尿崩症的关系

Relationship between protection of the hypophyseal stalk in pituitary adenoma microsurgery and postoperative diabetes insipidus

目的 分析和总结垂体腺瘤显微手术中避免损伤垂体柄的操作经验 ;探讨术中垂体柄的损伤与术后发生尿崩症的关系。方法 回顾性分析 30例垂体腺瘤显微手术中 ,镜下完整保护垂体柄结构 ,其术后发生尿崩症的情况 ,并复习相关文献。结果 30例垂体腺瘤显微手术均采用经眶额下入路 ,术中均可清楚见到垂体柄的解剖结构 ,避免过度牵拉和烧灼垂体柄。术后 2例患者发生暂时性尿崩症持续 2个月 ,未出现顽固性尿崩症。结论 垂体腺瘤显微手术后发生尿崩症与术中垂体柄损害有关 ,术中避免损伤垂体柄的操作 。

Objective To study the relationship between the reduction of hypophyseal stalk injury in microsurgery of pituitary adenoma and postoperative diabetes insipidus. Methods We retrospectively studied 30 cases of pituitary adenoma microsurgery in which the hypophyseal stalk was exposed clearly and protected carefully, researched the occurrence of postoperative diabetes insipidus, and reviewed related literature. Results All the 30 pituitary adenoma microsurgeries were done by the right subfrontal approach. In the operations, the hypophyseal stalk and hypophysio-portal system were protected carefully. We found 2 cases of postoperative transient diabetes insipidus, but no intractable diabetes insipidus. Conclusion The occurrence of postoperative diabetes insipidus is related to the injury of the hypophyseal stalk in pituitary adenoma microsurgery. Reducing the injury of the hypophyseal stalk in pituitary adenoma operations can decrease the occurrence and degree of postoperative diabetes insipidus.