神经内镜辅助下经双鼻孔-蝶窦入路切除垂体瘤

Treatment of pituitary adenoma via double nostril-transsphenoidal approach by neuroendoscopy

目的研究神经内镜下经双鼻孔-蝶窦入路切除垂体瘤的手术优势。方法神经内镜辅助下经双鼻孔-蝶窦入路切除垂体瘤51例,回顾性分析患者的临床资料,总结手术疗效。结果肿瘤全切除38例(74.5%),近全切除11例(21.5%),部分切除2例(3.9%)。术后发生脑脊液漏3例(5.8%),暂时性尿崩症17例,经积极处理后均治愈。术后3个月随访无死亡病例及严重后遗症,手术时间为30 min^180 min,平均约81.4 min。随访3个月~12个月,平均6个月,原有症状均有不同程度改善。结论神经内镜经双鼻孔-蝶窦入路切除垂体瘤是一种创伤小、安全有效的治疗方法,随着术者手术技巧的熟练和经验的提高、内镜配套器械的完善,以及Surgical止血纱布等新型材料的应用,其临床应用必定会越来越广泛。

ObjectiveTo study the operation advantage of the Treatment of pituitary adenoma via double nostril-transsphenoidal approach by neuroendoscopy.MethodsTreatment of pituitary adenoma via double nostril-transsphenoidal approach by neuroendoscopy 51 cases,a retrospective analysis of clinical data of patients, summarize the effects of the operations.Resultsthe tumor removal was total in 38 cases（74.5%）,subtotal in 11 cases （21.5%）,partial in 2 cases（3.9%）. Nasal cerebrospinal fluid leaks,occurred in 3 cases（5.8%）,temporary diabetes insipidus in 17 cases（33.3%）,after active treatment were cured. Review of head MRI and preoperative imaging was compared,March follow-up,no deaths and serious sequelae,operation time is 30-180 minutes,average 81.4 minutes. Patients were followed up for 3 - 12 months,average 6 months,most symptoms were improved.Conclusiont Treatment of pituitary adenoma via double nostril-transsphenoidal approach by neuroendoscopy is a minimally invasive,safe and effective,with the improvement of operation skills of skill and experience to improve,endoscopic matching apparatus, and the application of surgical gauze for hemostasis,Treatment of pituitary adenoma via double nostril-transsphenoidal approach by neuroendoscopy will be more widely spread.