单鼻腔蝶窦入路显微手术治疗垂体腺瘤  

Transsphenoid surgery through unilateral nasal cavity-an ideal surgery for pituitary adenomas.

作　　者：姜曙[1] 鞠延[1] 唐建建[1] 吴文韬[1] 毛伯镛[1] 黄思庆 

机构地区：[1]四川大学华西医院,四川成都610041

出　　处：《四川医学》2004年第8期859-860,共2页Sichuan Medical Journal

摘　　要：目的　探讨经单鼻腔蝶窦入路显微手术治疗垂体腺瘤的临床效果、手术适应症和并发症的防治。方法　总结分析经单鼻腔蝶窦入路显微手术治疗的 65例垂体腺瘤的临床表现、内分泌学变化、手术入路的选择原则、手术要点、并发症的防治方法。结果　术后MRI显示肿瘤全切除率 86 1% ,43例功能性腺瘤术后激素水平恢复正常率 76 7% ,无手术死亡、颅内感染、出血、癫痫等严重并发症 ;仅有 10 8%发生脑脊液鼻漏 ,经术中处理 ,术后行腰穿置管脑脊液持续引流治疗 ,均痊愈。结论　经单鼻腔蝶窦入路显微手术切除垂体腺瘤疗效满意 ,具有微侵袭、体表无切口、手术时间短(平均约 1h)、全切率高、手术死亡率低、并发症少、术后康复时间短 (平均 5天 )、垂体功能保存率高、患者生存质量高等优点 。Objective To summarize the experience in treating pituitary adenomas by transsphenoidal approach through unilateral nasal cavity,including clinical efficacy,surgical indications and complications.Methods 65 cases of pituitary adenomas were analysed to evaluate the clinical characteristics,abnormalities of incretion,selection of surgical approaches and prevention of surgical complications.Results After operation,86.1% cases of adenomas were resected completely in MRI follow-ups,and normal incretionary states were achieved in 76.7% of 43 functional adenomas.There had been no patients suffering from severe complications such as death,intracranial infection,bleeding,insults of carotid artery and cranial nerves,epilepsy and so on.CSF leakage occurred in 10.8% cases which were cured with fascia,fat tissure and glues,while continuous lumbar punture was considered to be the complementary method to treat the CSF leakage.Conclusion Transsphenoidal approaches was the ideal preferrable approach to resect the pituitary adenomas.

关 键 词：垂体腺瘤 经鼻 经蝶 外科治疗 并发症 

分 类 号：R736.4[医药卫生—肿瘤]