经蝶窦入路假包膜外切除功能性垂体腺瘤

Transsphenoidal pseudocapsule-based extracapsular resection of functioning pituitary adenomas

目的探讨经蝶窦入路假包膜外切除功能性垂体腺瘤疗效。方法回顾性分析28例采用经蝶窦入路假包膜外切除功能性垂体腺瘤的病例,术后随访6～24个月。结果 28例垂体腺瘤病人均在显微镜下全切肿瘤,术后病人临床症状改善,内分泌学检查激素水平恢复正常。术中发生脑脊液漏3例,术中修补后痊愈。术后发生一过性尿崩5例,使用醋酸去氨加压素治疗后得到控制,无垂体功能低下及死亡病例。结论经鼻蝶假包膜外切除功能性垂体腺瘤可提高治愈率,减少并发症发生,值得临床推广与运用。

Objective To evaluate the therapeutic effectiveness of transsphenoidal pseudocapsule-based extracapsular resection（TPER）of functioning pituitary adenomas（FPAs）. Methods The clinical data of 28 FPA patients undergoing TPER surgery were analyzed retrospectively. The patients were followed up for 6 to 24 months. Results All the patients underwent total removal of the tumor under the microscope. After the operation, the clinical symptoms of patients were improved, the hormone levels returned to normal.Intraoperative cerebrospinal fluid leakage occurred in 3 patients, no leakage was found after repair. Postoperative transient diabetes insipidus occurred in 5 patients and was controlled with Minirin. There was no hypopituitarism and death. Conclusions TPER of functional pituitary adenomas can improve the cure rate and reduce complications, thus being worthy of clinical use.