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Microsurgical Resection of Pituitary Adenoma via Single-Nostril Transsphenoidal Approach
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作者 Hengzhu Zhang Xian Zhang Hongmei Du Yongkang Wu Lun Dun Lei She Xiaodong Wang Xueqiang Shi Cunlin Xu 《Clinical oncology and cancer researeh》 CAS CSCD 2009年第6期446-450,共5页
OBJECTIVE To explore the methods and experience of thesingle-nostril transsphenoidal approach for treating pituitaryadenomas.METHODS We retrospectively analyzed 46 patients whohad pituitary tumors and received surgery... OBJECTIVE To explore the methods and experience of thesingle-nostril transsphenoidal approach for treating pituitaryadenomas.METHODS We retrospectively analyzed 46 patients whohad pituitary tumors and received surgery via the singlenostriltranssphenoidal approach and observed the effects andcomplications of surgery. The specific surgical methods are: a nasalspeculum is inserted slowly through the right nostril towards theanterior wall of the sphenoid sinus. A 1.5 cm incision is made intothe nasal mucosa in the right nasal cavity at the level of the middlenasal turbinate. By fracturing the bony septum, a space is formedbetween the bilateral nasal mucosa and the bony septum of thesphenoid sinus. Then, the inside of the sphenoid sinus is exposed.The remaining part of the bony septum, the anterior sphenoidsinus wall, and the sphenoid mucosa are gradually removed. Theanterior sphenoidotomy is less than 1.5 cm wide. After confirmingthe tumor by dural puncture, a cross incision of the dura is made,and the tumor is slowly removed by curette. The sella is usuallycollapsed and visible after the total tumor removal. When thetumor is resected satisfactorily, gelatin sponges are placed into theoperative cavity to stop bleeding.RESULTS Postoperative MRI scans revealed that among the 46cases, total resection of the tumor was achieved in 34 cases andsubtotal in 12. No deaths or disability occurred, and the hormonelevels of almost all patients improved. Signs of diabetes insipidusoccurred in 17, electrolyte disturbances in 5, and there were noreports of postoperative cerebrospinal fluid rhinorrhea.CONCLUSION The direct single nostril transsphenoidalapproach of continuous improvement has the advantages ofa convenient approach, simplified operation, safety and highefficiency. 展开更多
关键词 single-nostril transsphenoid approach MICROSURGERY pituitary adenoma.
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Neuroendoscopic and microscopic transsphenoidal approach for resection of nonfunctional pituitary adenomas 被引量:7
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作者 Zhi-Quan Ding Sheng-Fan Zhang Qing-Hua Wang 《World Journal of Clinical Cases》 SCIE 2019年第13期1591-1598,共8页
BACKGROUND Nonfunctional pituitary adenoma is a common type of pituitary adenoma, which can lead to headache, visual field disturbance, and cranial nerve damage due to increased tumor volume. Neuroendoscopic and micro... BACKGROUND Nonfunctional pituitary adenoma is a common type of pituitary adenoma, which can lead to headache, visual field disturbance, and cranial nerve damage due to increased tumor volume. Neuroendoscopic and microscopic transsphenoidal approaches have been widely used in the resection of nonfunctional pituitary adenomas. However, the clinical efficacy in neuroendoscopic and microscopic surgery is still controversial. AIM To explore the clinical efficacy of neuroendoscopic and microscopic transsphenoidal approach for resection of nonfunctional pituitary adenomas. METHODS We retrospectively analyzed 251 patients with nonfunctional pituitary adenomas;138 underwent neuroendoscopic surgery via transsphenoidal approach, and 113 underwent microscopic surgery via transsphenoidal approach between July 2010 and September 2015. All patients were followed up for > 6 mo. Gender, age, course of disease, tumor diameter, tumor location, and percentage of patients with headache, visual impairment, sexual dysfunction, and menstrual disorders were contrasted between the two groups to compare the difference of preoperative data. Cure rate, symptom improvement rate, recurrence rate, the postoperative hospital stay, operating time, intraoperative blood loss, and the incidence of postoperative complications were compared in order to evaluate the advantages and disadvantages of neuroendoscopic and microscopic surgery.RESULTS There was no significant difference in cure rate, symptom improvement rate, and recurrence rate between neuroendoscopy group and microscopy group (82.6% vs 85.8%, P > 0.05;90.6% vs 93.8%, P > 0.05;5.1% vs 9.7%, P > 0.05). In the neuroendoscopy group, the postoperative hospital stay was 8.4 ± 0.6 d;operating time was 167.2 ± 9.6 min;intraoperative blood loss was 83.4 ± 9.3 mL, and the rates of diabetes insipidus and electrolyte imbalance were 4.3% and 8.0%, respectively. The corresponding results in the microscopic group were 11.2 ± 0.6 d, 199.7 ± 9.3 min, 138.8 ± 13.6 mL, and 32.7% and 20.4%, respectively. There were significant differences in postoperative hospital stay, operating time, intraoperative blood loss, and the rates of diabetes insipidus and electrolyte imbalance between the two groups (P < 0.05). CONCLUSION Neuroendoscopic and microscopic transsphenoidal approaches have similar clinical efficacy for the resection of nonfunctional pituitary adenomas. Neuroendoscopic surgery reduces operating time, intraoperative bleeding, postoperative recovery, and complications. 展开更多
关键词 NONFUNCTIONAL PITUITARY ADENOMAS NEUROENDOSCOPY Microscopy transsphenoidal approach Clinical efficacy
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The Observation of Pituitary Function in Patients with Acute Pituitary Apoplexy before and after Transsphenoidal Surgery
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作者 何跃 张华楸 +5 位作者 李勇 李雄 王雄伟 舒凯 雷霆 李龄 《The Chinese-German Journal of Clinical Oncology》 CAS 2006年第3期194-196,共3页
Objective: To explore the pituitary function of acute pituitary apoplexy and its effect by transsphenoidal surgery. Methods: The clinical data and endocrine hormones level of 25 patients with acute pituitary apoplex... Objective: To explore the pituitary function of acute pituitary apoplexy and its effect by transsphenoidal surgery. Methods: The clinical data and endocrine hormones level of 25 patients with acute pituitary apoplexy who underwent transsphenoidal surgery from Jan. 2002 to June 2004 were retrospectively analyzed. Results: 13 cases underwent surgery within 3 days after admission and 22 cases within 1 week. Of the 25 cases, 9 patients suffered the impairment of pituitary-thyroidal function, 14 cases of pituitary-adrenal function and 11 cases of pituitary-gonadal function before surgery. After surgery, 5/9, 8/14 and 7/11 were recovered from the corresponding hypopituitarism. Conclusion: Hypopituitarism is a major manifestation of acute pituitary apoplexy. Urgent surgery decompression contributed to the improvement of pituitary function. Patients with hypopituitarism after surgery required the corresponding hormones replacement therapy. 展开更多
关键词 acute pituitary apoplexy transsphenoidal approach MICROSURGERY pituitary function
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Transsphenoidal microsurgical treatment of infradiaphragmatic craniopharyngioma 被引量:2
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作者 Ting Lei Baofeng Wang +5 位作者 Juan Chen Yu Xu Kai Shu Wei Sun Shaozheng Liu Xiaopeng Li 《Oncology and Translational Medicine》 2016年第5期197-202,共6页
Objective Typically,the transcranial approach has been used for the treatment of craniopharyngiomas with suprasellar extension,whereas the transsphenoidal approach has been used mostly for infradiaphragmatic craniopha... Objective Typically,the transcranial approach has been used for the treatment of craniopharyngiomas with suprasellar extension,whereas the transsphenoidal approach has been used mostly for infradiaphragmatic craniopharyngioma.Total resection of craniopharyngioma can reduce the recurrence rate,especially in young children,but it may lead to severe complications.Therefore,any benefit of the degree of resection must be weighed against the risk of complications by the surgeons.The purpose of this study was to explore the therapeutic outcome after transsphenoidal microsurgical treatment of infradiaphragmatic craniopharyngioma and share our experiences.Methods Between January 2003 and June 2013,30 patients with infradiaphragmatic craniopharyngioma underwent transsphenoidal microsurgical resection in our hospital.The neurological,visual,and endocrine functions,and extent of resection were analyzed retrospectively.Recurrence or growth of residual tumor tissue during follow-up was assessed using magnetic resonance imaging(MRI).Results Total resection was achieved in 25 patients(83.3%),subtotal resection was achieved in 4 patients(13.3%),and partial resection was achieved in 1 patient(3.4%).There were no perioperative deaths.Cerebrospinal fluid(CSF) leakage occurred in 6 patients,and among them,2 required surgical repair of the sella.New-onset postoperative diabetes insipidus(DI) developed in 8 patients.Vision and visual fields were improved at different levels in 13 out of 16 patients who had sight impediments before treatment.Tumor recurrence and regrowth was observed in 2 patients;1 patient underwent transsphenoidal reoperation,the condition of the other patient who had undergone several craniotomies grew worse over the 6-month follow-up period.Conclusion Transsphenoidal surgery is an ideal choice in treating infradiaphragmatic craniopharyngioma.The transsphenoidal approach,which preserves pituitary function and avoids damage to the hypothalamic structures and optic nerve,is associated with fewer complications than the transcranial approach and a low mortality rate. 展开更多
关键词 CRANIOPHARYNGIOMA transsphenoidal approach therapeutic effect
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ENDOSCOPY ASSISTED TRANSSPHENOIDAL PITUITARY SURGERY
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作者 李骁雄 熊文浩 +1 位作者 李善泉 戴炯 《Journal of Shanghai Second Medical University(Foreign Language Edition)》 2003年第1期58-61,共4页
Objective To discuss the surgical procedures and its advantages and disadvantages.Methods Theunilateral trans-septal endonasal approach was employed. Zero degree neuroendoscope was used for nasal mucosal dissection an... Objective To discuss the surgical procedures and its advantages and disadvantages.Methods Theunilateral trans-septal endonasal approach was employed. Zero degree neuroendoscope was used for nasal mucosal dissection and exploration of anterior wall of sphenoid sinus. The sphenoidotomy was done with the anatomic landmark of inferior margin of middle turbinate and ostia . After the identification of internal carotid artery and optic nerve, the pituitary fossa was opened. Then cut the dura , the margin between adenoma and normal tissue was very clear under endoscope. tumor can be removed safely. There were two patients with suprasellar extension, 30-degree endoscope was used and excellent visualization and tumor removal were obtained. Results No severe complication occurred. Conclusion Endoscopic assisted transsphenoidal pituitary surgery is practical because the operation is done under excellent illumination and visualization. 展开更多
关键词 neuro-endoscope transsphenoidal approach pituitary tumor
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Transsphenoidal pituitary surgery with one endonasal incision and modified repairation of sella floor
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作者 耿軍 耿瑞明 陳碩朗 《镜湖医学》 2003年第1期16-18,共3页
Objective To study the advantage of modified methods involving incision,repairation of the sella floor etc.in transsphenoidal approach for pituitury tumor removal.Methods The transsphenoidal approach with one endonasa... Objective To study the advantage of modified methods involving incision,repairation of the sella floor etc.in transsphenoidal approach for pituitury tumor removal.Methods The transsphenoidal approach with one endonasal incision of mucosa was performed for resecting pituitary tumor in 86 patients,of which total resection of the tumor in 67 cases and subtotal in 19 cases.Results There was no case with postoperative meningitis and rhinoseptal perforation.Tachocombs were used for repairation of the tumor resection cavection cavity and the sella floor,of which there was no case with postoperative CSF leakage happened.Conclusion These modified methods simplified operative procedurej Areduced damage and prevented postoperative complications of CSF leakage and rhinoseptal perforation etc. 展开更多
关键词 Pituitary tumor transsphenoidal approach Operative technique
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3D打印技术用于经鼻蝶窦入路垂体腺瘤切除术应用效果及对血清MMP-9和IGF-1水平的影响
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作者 韩莹 陈兴河 +2 位作者 王永恒 赵锦程 吴磊 《中国医学装备》 2024年第4期112-116,共5页
目的:探究3D打印技术在经鼻蝶窦入路垂体腺瘤(PA)切除术的应用效果及对血清基质金属蛋白酶-9(MMP-9)和胰岛素样生长因子-1(IGF-1)水平的影响。方法:选取2020年5月至2022年5月秦皇岛市第一医院收治的84例PA患者,按照随机数表法将其分为... 目的:探究3D打印技术在经鼻蝶窦入路垂体腺瘤(PA)切除术的应用效果及对血清基质金属蛋白酶-9(MMP-9)和胰岛素样生长因子-1(IGF-1)水平的影响。方法:选取2020年5月至2022年5月秦皇岛市第一医院收治的84例PA患者,按照随机数表法将其分为观察组和对照组,每组42例。对照组行经鼻蝶窦入路垂体腺瘤切除术,观察组行经鼻蝶窦入路垂体腺瘤切除术联合应用3D打印技术,比较两组肿瘤切除效果、围术期指标、视力改善情况、MMP-9和IGF-1水平,以及鼻腔功能的鼻气道阻力(NAR)、T&T嗅觉测试评分及并发症。结果:观察组肿瘤切除效果优于对照组,差异有统计学意义(U=2.286,P<0.05);观察组手术时间、术中出血量及住院时间均少于对照组,差异有统计学意义(t=4.780、11.438、11.842,P<0.05);术后3 d、7 d时观察组血清MMP-9和IGF-1水平低于对照组,差异有统计学意义(F=7.526、4.985,P<0.05);术后1个月、3个月时观察组NAR及T&T嗅觉测试评分低于对照组,差异有统计学意义(F=6.359、8.436,P<0.05);两组视力视野改善情况及并发症发生率比较,差异无统计学意义(P>0.05)。结论:3D打印技术用于经鼻蝶窦入路垂体腺瘤切除术可提高肿瘤切除效果,优化手术操作,减少创伤,有利于减轻疼痛,改善嗅觉功能与视力视野,并能降低血清MMP-9、IGF-1水平,且安全性较高。 展开更多
关键词 垂体腺瘤 经鼻蝶窦入路垂体腺瘤(PA)切除术 3D打印技术 基质金属蛋白酶-9(MMP-9) 胰岛素样生长因子-1(IGF-1)
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神经内镜经鼻经蝶入路手术切除颅咽管瘤的临床效果及安全性
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作者 王天恩 《实用癌症杂志》 2024年第8期1257-1259,共3页
目的探讨神经内镜经鼻经蝶入路手术切除颅咽管瘤的临床效果及安全性。方法选择2020年3月至2023年4月郑州大学第一附属医院收治的76例颅咽管瘤患者,根据随机数字表法分为治疗组与参考组,各38例。治疗组行神经内镜经鼻经蝶入路手术治疗,... 目的探讨神经内镜经鼻经蝶入路手术切除颅咽管瘤的临床效果及安全性。方法选择2020年3月至2023年4月郑州大学第一附属医院收治的76例颅咽管瘤患者,根据随机数字表法分为治疗组与参考组,各38例。治疗组行神经内镜经鼻经蝶入路手术治疗,参考组行经颅入路手术治疗。对比2组手术指标、临床疗效、并发症发生情况。结果治疗组术中出血量少于参考组,手术时间、切除肿瘤时间、住院时间较参考组短,有统计学差异(P<0.05)。治疗组治疗总有效率为97.37%(37/38),高于参考组的78.95%(30/38),有统计学差异(P<0.05);治疗组并发症总发生率为2.63%(1/38),低于参考组的23.68%(9/38),有统计学差异(P<0.05)。结论神经内镜经鼻经蝶入路手术治疗颅咽管瘤可提高疗效,缩短手术时间,减少出血量与并发症发生,利于加快患者康复速度,安全有效。 展开更多
关键词 颅咽管瘤 经鼻经蝶入路手术 神经内镜 经颅入路手术
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鞍结节脑膜瘤的内镜经鼻及显微镜经颅入路的个体化选择及36例病例总结
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作者 高延年 周培志 +2 位作者 吕亮 尹森林 姜曙 《临床神经外科杂志》 2024年第2期132-136,141,共6页
目的通过分析患者肿瘤形态临床表现及影像资料,为更精准选择手术方案提供依据。方法回顾性分析四川大学华西医院神经外科单医疗组2019年2月—2021年2月经鼻及经颅入路治疗的36例鞍结节脑膜瘤患者资料,结合患者临床特征及国际评分系统,... 目的通过分析患者肿瘤形态临床表现及影像资料,为更精准选择手术方案提供依据。方法回顾性分析四川大学华西医院神经外科单医疗组2019年2月—2021年2月经鼻及经颅入路治疗的36例鞍结节脑膜瘤患者资料,结合患者临床特征及国际评分系统,探讨选择手术入路需要分析的因素。结果本组患者中,神经内镜经鼻入路24例,显微镜经颅入路12例,随访时间24~48个月,结合最新的鞍结节脑膜瘤手术入路评分系统及本组诊疗经验进行综合判定,选择不同手术入路。随访均未见复发。结论鞍结节脑膜瘤术前影像学评分有助于个体化选择手术入路,内镜经鼻入路及显微镜经颅入路相互补充,合理选择可全切肿瘤、减少并发症,改善预后。 展开更多
关键词 鞍结节脑膜瘤 内镜经鼻蝶入路 经颅入路 并发症
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舒适护理对经鼻蝶入路垂体瘤切除术患者围手术期的影响
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作者 胡静 李雪妍 《安徽医专学报》 2024年第3期57-59,共3页
目的:探讨神经内镜下经鼻蝶入路垂体瘤切除术患者围手术期采用舒适护理的效果。方法:选择医院收治的150例垂体瘤手术切除患者作为研究对象,按随机数表法分成对照组和观察组,每组75例患者,且分别于围术期予以常规护理、舒适护理。对两组... 目的:探讨神经内镜下经鼻蝶入路垂体瘤切除术患者围手术期采用舒适护理的效果。方法:选择医院收治的150例垂体瘤手术切除患者作为研究对象,按随机数表法分成对照组和观察组,每组75例患者,且分别于围术期予以常规护理、舒适护理。对两组护理效果进行对比。结果:护理后,观察组患者焦虑自评量表、抑郁自评量表评分低于对照组,差异有统计学意义(P<0.05);护理后,观察组患者舒适度评分、总满意度评分均高于对照组,差异有统计学意义(P<0.05)。结论:舒适护理应用在神经内镜下经鼻蝶入路垂体瘤切除术患者围术期能消除其负面情绪,提高舒适度及增加满意度,值得推荐。 展开更多
关键词 垂体瘤切除 舒适护理 经鼻蝶入路
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卡麦角林联合神经内镜辅助下经鼻蝶窦垂体瘤切除术治疗老年垂体瘤对PRL HGH及ACTh水平的影响
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作者 王磊 周新管 《中国实用神经疾病杂志》 2024年第7期837-842,共6页
目的探讨卡麦角林与神经内镜下经鼻蝶窦垂体瘤切除术联用对老年垂体瘤患者的治疗效果及对泌乳素(PRL)、促肾上腺皮质激素(ACTh)、生长激素(HGH)的影响。方法选取2020-05—2023-05运城市中心医院收治的老年垂体瘤患者82例,随机分为对照... 目的探讨卡麦角林与神经内镜下经鼻蝶窦垂体瘤切除术联用对老年垂体瘤患者的治疗效果及对泌乳素(PRL)、促肾上腺皮质激素(ACTh)、生长激素(HGH)的影响。方法选取2020-05—2023-05运城市中心医院收治的老年垂体瘤患者82例,随机分为对照组41例,研究组41例。对照组采用神经内镜下经鼻蝶入路手术治疗,研究组在此基础上加用卡麦角林。比较2组总有效率、激素水平、炎症因子指标、生活质量评分及治疗安全性。结果研究组总有效率(92.68%)较对照组(75.61%)更高(P<0.05)。2组患者的激素水平均有明显改善,研究组PRL、ACTH、HGH水平显著低于对照组(P<0.05)。2组治疗后炎症因子水平均下降,研究组基质金属蛋白酶2(MMP-2)、Xklp2靶蛋白(TPX2)、P53蛋白水平显著低于对照组(P<0.05)。治疗后2组患者的生活质量均明显改善,研究组生活质量量表(SF-36)评分显著高于对照组(P<0.05)。2组治疗安全性无统计学差异(P>0.05)。结论对老年垂体瘤患者采用神经内镜下经典术式与卡麦角林联合治疗,可有效提高患者的生活质量,减轻炎症反应,效果较为理想,临床应用价值较高。 展开更多
关键词 垂体瘤 经鼻蝶窦入路切除术 神经内镜 卡麦角林 泌乳素 促肾上腺皮质激素 生长激素
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鞍区肿瘤外科研究进展
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作者 闫长祥 刘宁 《中国耳鼻咽喉颅底外科杂志》 CAS CSCD 2023年第3期1-4,共4页
鞍区肿瘤手术复杂,并发症多。传统的开颅手术和新兴的内镜经鼻技术,均存在优劣势。如何提高肿瘤的切除率、降低术后并发症始终是鞍区肿瘤外科治疗的难点和热点。本文对鞍区肿瘤的发展现状、手术入路、神经内镜经鼻蝶入路切除鞍区肿瘤技... 鞍区肿瘤手术复杂,并发症多。传统的开颅手术和新兴的内镜经鼻技术,均存在优劣势。如何提高肿瘤的切除率、降低术后并发症始终是鞍区肿瘤外科治疗的难点和热点。本文对鞍区肿瘤的发展现状、手术入路、神经内镜经鼻蝶入路切除鞍区肿瘤技术、鞍底重建等进行阐述,并对鞍区肿瘤的外科治疗的发展方向进行展望。 展开更多
关键词 神经内镜 鼻蝶入路 鞍区 肿瘤 手术
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颅底硬膜缝合技术在内镜经鼻蝶入路鞍区肿瘤切除中的应用
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作者 周律 王斌 +5 位作者 王毅 吕波 单明 叶雷 高鹏 程宏伟 《国际神经病学神经外科学杂志》 2023年第1期9-14,共6页
目的探讨颅底硬膜缝合技术在内镜经鼻蝶入路切除鞍区肿瘤后颅底重建中的可行性和可靠性。方法分析安徽医科大学第一附属医院2019年1月—2021年7月在内镜下经鼻蝶入路切除鞍区肿瘤后采用颅底硬膜缝合技术处理的28例患者临床资料,并进行... 目的探讨颅底硬膜缝合技术在内镜经鼻蝶入路切除鞍区肿瘤后颅底重建中的可行性和可靠性。方法分析安徽医科大学第一附属医院2019年1月—2021年7月在内镜下经鼻蝶入路切除鞍区肿瘤后采用颅底硬膜缝合技术处理的28例患者临床资料,并进行相关文献复习。结果28例患者均存在术中脑脊液漏(CSFL),参照Esposito分级法,术中发生1级CSFL 14例,2级CSFL 10例,3级CSFL 4例。术中均采用了硬膜缝合技术修补鞍底,27例患者一期颅底重建成功,无术后CSFL发生,1例Rathkes囊肿患者术后出现CSFL,再次接受内镜下CSFL修补术,术后未再出现CSFL。结论颅底缝合硬膜,可以对颅底产生较大的支撑力,重建效果确切,值得临床应用。 展开更多
关键词 脑脊液漏 硬膜缝合技术 神经内镜 脑肿瘤 经鼻蝶入路
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锁孔入路切除和鼻蝶窦入路切除对脑垂体瘤患者颅内血肿、脑脊液鼻漏发生率的影响 被引量:7
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作者 石玲红 党帅 +1 位作者 陈烈冉 和青森 《实用癌症杂志》 2023年第2期283-286,共4页
目的探讨锁孔入路切除和鼻蝶窦入路切除对脑垂体瘤患者颅内血肿、脑脊液鼻漏发生率的影响。方法选取82例脑垂体瘤患者作为研究对象,将其随机分为A组(n=45)和B组(n=37)。其中A组患者行显微镜下锁孔入路切除术,B组患者行神经内镜下鼻蝶窦... 目的探讨锁孔入路切除和鼻蝶窦入路切除对脑垂体瘤患者颅内血肿、脑脊液鼻漏发生率的影响。方法选取82例脑垂体瘤患者作为研究对象,将其随机分为A组(n=45)和B组(n=37)。其中A组患者行显微镜下锁孔入路切除术,B组患者行神经内镜下鼻蝶窦入路切除术。比较两组患者临床疗效、手术指标、肿瘤全切率和内分泌下降情况以及术后颅内血肿、脑脊液鼻漏发生率。结果治疗后A组治愈19例(42.22%),显效8例(17.78%),有效8例(17.78%),无效10例(22.22%);B组治愈23例(62.16%),显效8例(21.62%),有效4例(10.81%),无效2例(5.41%)。A组有效率(77.78%)低于B组(94.59%)(P<0.05)。A组手术时间(93.42±21.75)min显著长于B组(65.82±17.44)min(P<0.05);住院时间(9.79±1.27)d显著长于B组(6.08±1.16)d(P<0.05);A组术中失血量为(76.71±8.45)ml,显著多于B组(50.62±6.73)ml(P<0.05)。A组中肿瘤全切35例(77.78%),B组全切35例(94.59%);A组出现内分泌激素下降20例(44.44%),B组出现下降25例(67.57%)。A组肿瘤全切率与内分泌激素下降比例均明显低于B组(P<0.05)。A组术后出现颅内血肿和脑脊液鼻漏分别为3例(6.67%)和7例(15.56%),B组出现脑脊液鼻漏2例(5.41%),未出现颅内血肿,A组颅内血肿和脑脊液鼻漏发生率均高于B组,但无明显差异(P>0.05)。结论与锁孔入路切除术相比,鼻蝶窦入路切除垂体瘤对脑垂体瘤患者的疗效更好,能够增加肿瘤全切率,加速患者恢复,且颅内血肿和脑脊液鼻漏发生率明显更低,对患者预后质量价值更高。 展开更多
关键词 锁孔入路 脑垂体瘤 鼻蝶窦入路 颅内血肿 脑脊液鼻漏
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经蝶入路垂体腺瘤切除术后并发症与预防的研究进展 被引量:1
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作者 石英贵 郑勇 《中外医学研究》 2023年第8期175-179,共5页
垂体腺瘤作为颅内常见的良性肿瘤之一,经蝶入路切除病灶是治疗本病的首选手术方式,但术后多种并发症仍需特别关注,常见的并发症有抗利尿激素变化、垂体功能下降、电解质紊乱、脑脊液漏、感染、颅内出血、视力视野障碍、消化道出血、继... 垂体腺瘤作为颅内常见的良性肿瘤之一,经蝶入路切除病灶是治疗本病的首选手术方式,但术后多种并发症仍需特别关注,常见的并发症有抗利尿激素变化、垂体功能下降、电解质紊乱、脑脊液漏、感染、颅内出血、视力视野障碍、消化道出血、继发性空蝶鞍综合征等。这些并发症若处理不好可能会严重影响患者术后生存质量。本文收集近年来中英文文献对经蝶入路垂体腺瘤切除术后常见并发症及其防治进行综述,为患者术后并发症制定更好的预防及治疗方案。 展开更多
关键词 垂体腺瘤 并发症 经蝶入路
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经鼻蝶入路神经内镜手术和显微镜手术治疗垂体瘤的临床效果比较 被引量:1
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作者 苗海军 樊宇耕 +2 位作者 毛彦君 乔楠 马兵博 《临床医学研究与实践》 2023年第10期59-62,共4页
目的 比较经鼻蝶入路神经内镜手术和显微镜手术治疗垂体瘤的临床效果。方法 选取本院收治的45例垂体瘤患者,根据治疗方案的差异将其分为神经内镜组(25例,给予经鼻蝶入路神经内镜手术)和显微镜组(20例,给予经鼻蝶入路显微镜手术)。比较... 目的 比较经鼻蝶入路神经内镜手术和显微镜手术治疗垂体瘤的临床效果。方法 选取本院收治的45例垂体瘤患者,根据治疗方案的差异将其分为神经内镜组(25例,给予经鼻蝶入路神经内镜手术)和显微镜组(20例,给予经鼻蝶入路显微镜手术)。比较两组的治疗效果。结果 神经内镜组的手术时长、住院时间短于显微镜组,术中出血量少于显微镜组,肿瘤切除情况优于显微镜组(P<0.05)。术后1个月,两组的促肾上腺皮质激素(ACTH)、人生长激素(GH)、促甲状腺激素(TSH)、泌乳素(PRL)水平均明显降低,且神经内镜组低于显微镜组(P<0.05)。术后1个月,两组的视野指数(VFI)、模式标准差(PSD)、平均缺损(MD)均明显改善,且神经内镜组优于显微镜组(P<0.05)。术后1个月,两组的鼻腔鼻窦结局测试-20(SNOT-20)评分均明显降低,生活质量评分均明显升高,且神经内镜组优于显微镜组(P<0.05)。神经内镜组的并发症总发生率明显低于显微镜组(P<0.05)。结论 经鼻蝶入路神经内镜手术治疗垂体瘤可明显提高治疗效果,改善激素水平和视觉功能,并发症发生率更低,值得推广。 展开更多
关键词 鼻蝶入路 神经内镜手术 显微镜手术 垂体瘤 激素水平 视觉功能
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Transsphenoidal approach to pituitary adenoma: surgical technique of the Peking Union Medical College Hospital 被引量:1
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作者 LI Yong-Ning WANG Ren-zhi LI Gui-lin 《Chinese Medical Journal》 SCIE CAS CSCD 2009年第24期3086-3090,共5页
Although presented over one hundred years ago, the transsphenoidal approach to pituitary adenoma is still the most suitable and safe route to pituitary adenoma, with a series of significant evolutional steps. The tran... Although presented over one hundred years ago, the transsphenoidal approach to pituitary adenoma is still the most suitable and safe route to pituitary adenoma, with a series of significant evolutional steps. The transsphenoidal approach to pituitary adenoma is still a non-universal approach used in different centers of different areas in our country. The transsphenoidal approach has a number of variations, including the endonasal rhinoseptoplastic, transnasal displacement, 展开更多
关键词 transsphenoidal approach surgical technique pituitary adenoma
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神经内镜经鼻蝶入路切除无功能性垂体腺瘤的效果及对视觉功能的影响研究
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作者 杨震宇 《黑龙江医学》 2023年第11期1309-1311,共3页
目的:观察神经内镜经鼻蝶入路切除无功能性垂体腺瘤(NFPA)的效果及对视觉功能的影响。方法:选取2019年6月—2021年6月佳木斯市中心医院内分泌科收治的86例NFPA患者作为研究对象,采用随机数表法分为对照组和观察组,每组各43例。对照组给... 目的:观察神经内镜经鼻蝶入路切除无功能性垂体腺瘤(NFPA)的效果及对视觉功能的影响。方法:选取2019年6月—2021年6月佳木斯市中心医院内分泌科收治的86例NFPA患者作为研究对象,采用随机数表法分为对照组和观察组,每组各43例。对照组给予显微镜经鼻蝶入路切除术,观察组给予神经内镜经鼻蝶入路切除术。比较两组患者肿瘤切除率、围术期指标、患侧眼球加权视野指数(VFI)、视野平均缺损(MD)、模式标准差(PSD)及并发症发生情况。结果:观察组肿瘤全切除率高于对照组,差异有统计学意义(χ2=4.690,P<0.05)。观察组手术时间长于对照组,观察组术中失血量少于对照组,观察组住院时间短于对照组,差异有统计学意义(t=8.188、18.086、23.352,P<0.05)。术后,两组患者患侧眼球VFI增加,MD、PSD减少,且观察组患侧眼球VFI高于对照组,MD、PSD低于对照组,差异有统计学意义(t=4.715、39.665、24.263,P<0.05)。观察组并发症发生率明显低于对照组,差异有统计学意义(χ2=4.690,P<0.05)。结论:神经内镜经鼻蝶入路切除NFPA可明显提高患者肿瘤全切除率,促进其视觉功能恢复,降低其术后并发症发生率。 展开更多
关键词 神经内镜 经鼻蝶入路 无功能性垂体腺瘤 视觉功能 视野平均缺损
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大型垂体腺瘤经蝶显微外科切除技术 被引量:18
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作者 章翔 张剑宁 +7 位作者 费舟 顾建文 付洛安 刘卫平 王占祥 贺晓生 吴景文 易声禹 《解放军医学杂志》 CAS CSCD 北大核心 2002年第7期573-574,共2页
为探讨大型垂体腺瘤(LPA)经蝶入路、应用显微外科技术治疗的效果 ,作者对 15 2 0例LPA以颅骨X线平片、CT或MRI等影像学检查做出诊断 ,采取经蝶入路、显微镜下进行肿瘤切除术的病例进行了回顾性分析。结果表明 ,12 6 4例 (83 2 % )获全切... 为探讨大型垂体腺瘤(LPA)经蝶入路、应用显微外科技术治疗的效果 ,作者对 15 2 0例LPA以颅骨X线平片、CT或MRI等影像学检查做出诊断 ,采取经蝶入路、显微镜下进行肿瘤切除术的病例进行了回顾性分析。结果表明 ,12 6 4例 (83 2 % )获全切除 ,195例(12 8% )达次全切除 ,余 6 1例 (4 0 % )系哑铃型或纤维性腺瘤 ,仅获部分切除。手术后 2例 (0 1% )死亡。 12 4 0例进行平均 3 5年随访观察 ,有 12 19例 (98 3% )视力损害获得了恢复 ,仅 2 1例 (1 7% )无变化 ,但未见恶化 ;术前有视野缺损的 12 2 6例 ,术后 1186例 (96 7% )明显改善 ,4 0例 (3 3% )无变化。作者认为 ,除了纤维性或哑铃状LPA外 ,对大型或巨大型垂体腺瘤采取经蝶入路显微外科手术切除是一种安全、有效的方法 。 展开更多
关键词 垂体肿瘤 经蝶入路 显微外科 征象 手术方法
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溴隐亭在泌乳素腺瘤治疗中的应用 被引量:9
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作者 卢旺盛 岳志健 +4 位作者 周晓平 魏梁峰 洪波 王文仲 林富禄 《第二军医大学学报》 CAS CSCD 北大核心 2003年第8期914-915,共2页
82例泌乳素腺瘤中 ,直接予溴隐亭药物治疗 31例 ,行经蝶窦手术 5 1例 ;术后行放疗或药物治疗。对 12例复发型或残留者行再手术治疗、药物和放射治疗。平均随访时间为 3年。结果微腺瘤手术组与单纯药物组的月经好转率 (或男性性功能正常... 82例泌乳素腺瘤中 ,直接予溴隐亭药物治疗 31例 ,行经蝶窦手术 5 1例 ;术后行放疗或药物治疗。对 12例复发型或残留者行再手术治疗、药物和放射治疗。平均随访时间为 3年。结果微腺瘤手术组与单纯药物组的月经好转率 (或男性性功能正常率 )分别为 78.6 % (11/ 14 )、74 .2 % (2 4 / 31) ;泌乳素大腺瘤的总术后复发率 2 7.0 % (10 / 37) ,其中手术加药物与放疗组16 .7% (1/ 6 ) ,手术加放疗组 2 2 .2 % (2 / 9) ,手术加药物组 2 5 .0 % (3/ 12 )和单纯手术组 4 0 .0 % (4 / 10 ) ;血清泌乳素正常率则分别为 10 0 % (6 / 6 )、88.9% (8/ 9)、91.7% (11/ 12 )和 70 .0 % (7/ 10 )。出现药物不良反应 4例。认为溴隐亭治疗对泌乳素水平的控制及减少肿瘤复发率有明显疗效 。 展开更多
关键词 泌乳素腺瘤 治疗 溴隐亭 临床应用 放射疗法 经蝶窦手术
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