巨大垂体腺瘤的显微手术治疗

Microsurgical removal of giant pituitary adenomas

目的探讨巨大垂体腺瘤的显微手术全切及如何保护残余垂体功能方法。方法对连续收治的25例巨大垂体腺瘤患者行显微手术切除,其中额下入路13例,翼点入路6例;6例经单鼻孔蝶窦入路。对手术前后患者的影像学及内分泌结果进行对比。结果术后MR显示全切12例,次全切除10例,大部切除3例;激素水平降为正常者9例。结论巨大垂体腺瘤的手术应合理选择入路,追求影像学上的全切,同时注意保护残余垂体功能,减少并发症。

Objective To study the methods of total microsurgical resection of giant pituitary adenoma and to save the survival pituitary gland function.Methods Twenty-five consecutive cases of giant pituitary adenoma were treated microsurgically,13via subfrontal approach,6via pterional approach,6via single nostric-phenoid approach.The results of MRI and hormone level of pre-and postoperation was analysed.Results The postoperative MRI showed that tumor of12cases were total removed,10subtotal removed,3partial removed.The level of hormone at postoperation in9cases was normal.Conclusion The operative approach should rationally selected in the patients with giant pituitary adenomas,the survival pituitery gland function should be saved as better possible as,for decreasing complication.