巨大型垂体腺瘤经颅入路显微外科治疗  

Transcranial microsurgery for huge pituitary adenomas

作　　者：樊丰势[1] 王政刚[1] 张旭东[1] 张卫宁[1] 程建业[1] 赵亚鹏[1] 黄英雄[2] 李建衡[2] 

机构地区：[1]中国人民解放军白求恩国际和平医院神经外科,河北石家庄050080 [2]中国人民解放军第467医院神经外科,河北石家庄050081

出　　处：《中国微侵袭神经外科杂志》2004年第10期448-449,共2页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的对巨大型垂体腺瘤幕上显微外科治疗的经验进行总结。方法对21例巨大型垂体腺瘤(直径≥4cm)病人的病历资料进行总结,其中向鞍内-鞍上生长者12例,向一侧鞍旁5例,双侧鞍旁2例,鞍后2例。行经翼点入路14例,额下-翼点7例。术中利用解剖间隙首先囊内去除软质肿瘤,然后剥离鞍旁肿瘤包膜,注意保护垂体柄。结果肿瘤全切除13例(62%),大部切除8例,术后死亡2例。结论巨大型垂体腺瘤可经幕上入路,并根据肿瘤的生长类型适当扩大翼点切口,注意保护丘脑下部及视神经;术后应继续行抗肿瘤治疗。Objective To summarize our experience in treating huge pituitary adenomas. Methods 21 cases of pituitary adenomas (≥ 4cm)were operated via transcranial approach, include 12 cases of sella-suprasellar type, 5 unilateral parasellar type, 2 bilateral parasellar type, and 2 postsellar type. The transpterional approach was used in 14 cases and the subfrontal-transpterional was used in 7. Tumors were first evacuated, and then the tumor walls were carefully dissected. Results The tumors were totally removed in 13 cases and subtotally in 8. 2 patients died after operation because of hypothalamus damage. Conclusion The huge pituitary adenoma could be removed via transcranial approach, and the pterional incision could be enlarged according to the tumor development. We should pay more attention to protect the hypothalamus and optic nerves during operation,and anti-tumor therapy should be considered after the operation.

关 键 词：垂体腺瘤 显微外科 经颅入路 治疗 

分 类 号：R736.4[医药卫生—肿瘤] R651.13[医药卫生—临床医学]