内镜经鼻蝶切除垂体腺瘤术后并发症分析

An analysis of complications in patients underwent endoscopic transsphenoidal surgery for pituitary adenomas

目的分析内镜经鼻蝶窦入路切除垂体腺瘤术后的并发症。方法对40例内镜经鼻蝶窦入路切除垂体腺瘤手术并发症的临床资料进行回顾性分析。结果术中脑脊液鼻漏2例,经"三明治"修补后治愈;术后脑脊液鼻漏2例,经腰大池置管引流后治愈。术后出现暂时性尿崩4例,颅内感染1例,垂体分泌功能低下2例,蝶窦炎1例;经治疗后均好转。术后嗅觉障碍2例,经治疗后无好转。无死亡病例。结论术中规范精细操作、术后严密观察和积极有效处理并发症有助于提高内镜经鼻蝶垂体腺瘤切除手术效果。

Objective To analyze the complications of the patients underwent endoscopic transsphenoidal surgery for pituitary adenomas .Methods The data of complications in 40 patients underwent endoscopic transsphenoidal surgery for pituitary adenomas were retrospectively analyzed . Results The complications of 40 cases included intraoperative cerebrospinal fluid leakage in 2 cases , postoperative cerebrospinal fluid leakage in 2 cases ,transient diabetes insipidus in 4 cases ,intracranial infection in one case ,pituitary hypofunction in 2 cases ,sphenoid sinusitis in one case ,and olfactory dysfunction in 2 cases .The complications mentioned above were cured or improved by the treatments such as “sandwich” repairing for intraoperative cerebrospinal fluid leakage ,continuous lumbar drainage with lumbar catheter for postoperative cerebrospinal fluid leakage .But the olfactory disorder in 2 cases were not improved .No death case occurred in 40 cases .Conclusion A better efficacy of endoscopic pituitary adenoma surgery can be obtained by standardized and fine surgical operation , careful postoperative observation and effectively managing complications .