内镜下经鼻蝶入路治疗垂体腺瘤

Treatment of pituitary adenoma via endoscopic transnasal transsphenoidal approach

目的探讨内镜下经鼻蝶入路治疗垂体腺瘤的优势。方法回顾性分析42例内镜下经鼻蝶入路手术切除垂体腺瘤患者的临床资料,总结手术治疗经验,分析内镜下经鼻蝶入路手术的优缺点。结果术前视力受损的18例患者术后均有不同程度的视力改善;39例垂体瘤利用假包膜分离技术全切肿瘤,2例侵袭海绵窦的垂体瘤有残留;术后发生暂时性尿崩症11例,治疗后正常,2例出现永久性尿崩,无垂体功能低下的患者;1例出现脑脊液漏并发颅内感染,治疗后治愈,无死亡病例。结论内镜下经鼻蝶入路治疗垂体腺瘤的手术方法微创、安全、有效。

Objective To explore the advantages of endoscopic transnasal transsphenoidal approach in the treatment of pituitary adenoma. Methods Retrospectively analyzed clinical data of 42 pituitary adenoma patients treated by endoscopic transnasal transsphenoidal resection and summarize surgical treatment experience. Results There were 18 patients with preoperative visual impairment received postoperative vision improvement of different degrees, 39 patients received membrane separation technology resection for pituitary adenoma, 2 patients had residual of pituitary adenoma invading the cavernous sinus; 11 patients had postoperative temporary diabetes insipidus and became normal after treatment; 2 patient had perpetual diabetes insipidus, no patient had hypopituitarism; 1 patient had cerebrospinal leak complicated with intracranial infection and cured after treatment, and no patient dead. Conclusion Endoscopic transnasal transsphenoidal approach proves to be a minimally invasive, safe and effective method in the treatment of pituitary adenoma.