巨大型垂体腺瘤36例临床分析

Clinical analysis of giant pituitary adenomas:A report of 36 cases

目的 :探讨巨大型垂体腺瘤显微外科手术治疗的入路方法及效果。方法 :对 36例巨大型垂体腺瘤 ,根据肿瘤的生长方向及部位分别采用经蝶、经额下、额下经蝶、扩大经蝶、扩大额下硬膜外、额下 -翼点等手术入路 ,并在显微镜下配合电磁刀实施手术治疗。结果 :36例巨大型垂体腺瘤全切 19例 ,近全切 10例 ,大部切除 7例 ,复发 4例 ;病死 1例。平均随访 2年 ,证明手术治疗效果良好。结论 :依据巨大型垂体腺瘤的不同位置及生长方向选择适当的手术入路是提高全切率、降低死亡率及复发率的重要手段。显微手术结合电磁刀是安全切除肿瘤。

Objective:To study the approaches and effects of microsurgy in management of huge pituitary adenomas.Methods:Thirty six cases of huge pituitary adenomas were studied retrospectively.The tumors were removed by transsphenoidal,transsubfrontal,extended transsphenoidal,extended subfrontal extradual or subfrontal transpterional approaches.All patients were treated by microsurgery,using the electromagnetic field system.Results:Total removal was achieved in 19 cases,subtotal in 10 and partial in 7.One case died after operation;recurrence developed in 4 cases.Conclusions:Appropriate approach can elevate the rate of total tumor removal and decrease the mortality and recurrent rate.Microsurgery combined with electromagnetic knife is effective in removing the tumor and preserving the function of hypothalamus. [