老年患者垂体腺瘤的治疗

Treatment of elderly patients with pituitary adenoma

目的探讨老年患者垂体腺瘤治疗的手术入路及疗效。方法将35例老年垂体腺瘤手术患者分为两组,回顾性分析两组手术入路选择、治疗效果和随访情况。结果肿瘤总体全切率82.86%（29/35）,其中经单鼻孔-蝶窦入路组肿瘤全切率为80.95%（17/21）,经颅入路组肿瘤全切率为85.71%（12/14）。随访6~24个月,3例经蝶入路患者肿瘤复发,再次行经颅入路手术后恢复良好。结论经单鼻孔-蝶窦入路治疗垂体腺瘤创伤小、恢复快,适用于肿瘤位于鞍内、鞍上或向蝶窦生长的大部分老年患者。经双额底入路肿瘤全切率高,适用于肿瘤主要向鞍上及鞍旁生长的大型侵袭性肿瘤。

Objective To review the treatment of elderly patients with pituitary adenoma with two different operative approaches. Methods The clinical data of 35 elderly patients with pituitary adenom as under going surgical resection from 2007 through 2013,including21 cases treated with transsphenoidal approach and 14 treated with craniotom y, were retrospectively analy zed.Results The overall total resection rate of pituitary adenom as in twogroups was 82. 86 %（ 29 /35）; the total resection rate for transsphenoidal operation was 80. 95 %（ 17 /21） a nd that for craniotom y was 85. 71 %（ 12 /14）. Patients were followed-up for 6-24 m onth, 3 cases in transsphenoidal resection had tum or recurrence. Conclusion The transsphenoidal approach is suitable for adenom as growing towards the sphenoidal sinus and inner and superior sella region and transcranial approach is suitable for large or giant adenom as growing towards the upper sella and parasella region.