经单鼻孔-蝶窦入路切除垂体瘤35例分析

Analysis of 35 cases of pituitary adenomas resection by endonasal transsphenoidal approach

目的:探讨经单鼻孔-蝶窦入路显微手术切除垂体瘤的临床效果、手术方法及术后处理。方法:回顾性分析采用经单鼻孔-蝶窦入路显微手术治疗的35例垂体瘤患者的临床资料。结果:35例垂体瘤患者中,泌乳素腺瘤22例,生长激素腺瘤4例,非分泌性腺瘤9例。肿瘤全切27例,次全切除6例,大部分切除2例。术后发生电解质紊乱2例,暂时性尿崩症5例,脑脊液鼻漏1例,持续1周。没有发生视力恶化、颅神经损伤、感染、长期脑脊液漏等严重并发症,无死亡。结论:经单鼻孔-蝶窦入路显微手术切除垂体瘤具有创伤小,手术时间短,安全性高,并发症少,术后康复快,垂体功能保存率高等优点。严格把握好手术适应证和禁忌症,能使需要手术治疗的垂体瘤患者取得满意的治疗效果。

Objective：To study tje tecjmique amd postoperative treatmemt of simgle-mostril tramsspjemoidal pituitary ademoma microsurgery. Methods：Climical data of 35 patiemts witj pituitary tumor treated by microsurgical tecj-miques were amalyzed retrospectively. ResUlts：Amomg tje 35 cases,22 cases were PRL ademoma,4 cases were CH ad-emoma,amd 9 cases were mo fumctiomal ademoma. 27 cases accepted total resectiom,6 cases sub-total resectiom amd 2 cases most tumors resectiom. After surgery,electrolyte imbalamce occurred im 2 cases,tramsiemt diabetes imsipidus im 5 cases,amd 2 cases witj CSF rjimorrjea lastimg for two weeks. No deterioratiom of eyesigjt,cramial merve imjury,imfectiom amd otjer serious complicatioms,mo deatj. ConclUsion：Simgle-mostril tramsspjemoidal pituitary ademoma microsurgery jas advamtages of less destructive,savimg time,safety,less complicatioms,quicker recovery,amd keepimg good pituitary fumctiom. Strictly grasp tje surgical imdicatioms amd comtraimdicatioms cam make tje surgical treatmemt of pitui-tary tumors to acjieve a satisfactory tjerapeutic effect.