垂体柄与垂体腺瘤显微解剖关系的临床观察

Clinical observation of the microanatomical relation between pituitary stalk and pituitary adenoma

目的 观察垂体柄与肿瘤的解剖关系 ,以利术中保护垂体柄免受损伤。方法 在鞍膈平面 ,以鞍结节与鞍背两者中点的连线为标准 ,判断垂体柄的侧别位置。再将鞍膈平面视做时钟面板 ,进而判断垂体柄的时钟位。结果 71例观察中 ,垂体柄居左侧 17例 ,右侧 41例 ,后中位 13例。其中 46例以时钟位判断 ,5时位 13例 ,6时位 11例 ,7时位 7例 ,4时位 5例 ,3时位 4例 ,2、8及11时钟位各为 2例。结论 垂体柄的位置与肿瘤在鞍内的生长方向有关 ,与向鞍上扩展无关。

Objective To observe the microanatomical relation between the pituitary stalk and pituitary adenoma so as to find practical approach to protect the pituitary stalk during operation. Methods At the level of diapragma sellae, the laterality of pituitary stalk was assessed in 71 cases by its location to the line connecting the mid points of tuberculum sellae and dorsum sellae. In 46 cases the level of diaphragma sellae was regarded as the clock dial so as to determine the location by hour of the pituitary stalk. Results The laterality of pituitary stalk was observed in 61 cases, among which the pituitary stalk was on the left side in 17 cases, on the right side in 41 cases, and at the posterior middle site in 13 cases. Location by hour was observed in 46 cases, among which 13 cases were at 5 o′clock, 11 at 6 o′clock, 7 at 7 o′clock, 5 at 4 o′clock, 4 at 3 o′clock, 2 at 2 o′clock, 2 at o′clock, and 2 at 11 o′clock respectively. Conclusion The location of pituitary stalk is related to the direction of growth of tumor in the sella and not related to its extension above the sella. The pituitary stalk can beused as the marker to find normal pituitary tissue.