经鼻蝶入路显微手术预防和修补脑脊液鼻漏

Prevention and Repair of Cerebrospinal Rhinorrhea by Transsphenoidal Microsurgical Approach

目的 探讨经鼻蝶入路显微手术脑脊液鼻漏的预防和修补方法。方法 将改良经鼻蝶显微手术用于200例鞍区病变,其中150例为大或巨大垂体腺瘤,术前合并脑脊液鼻漏4例,1例外伤性脑脊液鼻漏,通过治疗观察并进行围手术期评价。结果 发现脑脊液漏可在手术中和手术后出现,通过术中的预防措施及术后的及时处理可以得到治愈。结论 经鼻蝶入路显微手术为鞍区病变术中和术后预防和修补脑脊液鼻漏的良好方法。

Objective To investigate the methods of prevention and repair of cerebrospinal rhinorrhea by transsphenoidal microsurgical approach. Methods 200 patients with sellar lesion were treated by trans-sphenoidal approach, including 150 patients with pituitary macroadenoma, 4 with cerebrospinal rhinorrhea preoperatively, and 1 patients with traumatic cerebrospinal rhinorrhea. Perioperative evaluation was made during treatment and observation. Results Cerebrospinal rhinorrhea occurred perioperatively and could be cured through intraoperative step and postoperative treatment. Conclusion Transsphenoidal microsurgical approach is a good method for the treatment of perioperative cerebrospinal rhinorrhea in sellar lesions.