大、巨型垂体腺瘤的手术入路选择  

The choice of surgical approach to pituitary macroadenoma

作　　者：孙伟建[1] 徐温理 张柏年[1] 张保民[1] 段炼[1] 杨伟中[1] 邓春江[1] 孙书勤 

机构地区：[1]军事医学科学院附属医院

出　　处：《军事医学科学院院刊》1996年第1期57-59,共3页Bulletin of the Academy of Military Medical Sciences

摘　　要：自１９９０年以来收治直径在２～５．６ｃｍ的大、巨型垂体腺瘤３３例。依肿瘤生长形态与扩展范围将其简略分为三种类型。Ａ型：瘤体位于鞍内或侵入蝶窦；Ｂ型：瘤体呈椭圆形或哑铃形向鞍上扩展，三脑室明显移位抬高；Ｃ型：瘤体巨大侵入三脑室阻塞室间孔或明显的鞍周扩展。本组Ａ型７例，Ｂ型１８例，Ｃ型８例。根据肿瘤生长类型不同分别采取不同的手术入路切除肿瘤，Ａ型均采取经蝶入路，Ｂ型采用经蝶或开颅手术，Ｃ型均行开颅手术。肿瘤全切除９例，大部分切除１８例，部分切除６例，无１例死亡。现着重就大。A series of 33 patients with pituitary macroadenomas (diameter 20 56 mm) were treated from 1990.The tumors were classified as three types according to tumor configuration and extension.Type A tumors are those confined within the sella or extending into the sphenoid sinus.Type B tumors are those with suprasellar extension and marked elevation of third ventricle.Type C tumors are those with extreme suprasellar and parasellar extension or extending into third ventricle and obstructing the foramen of Monro.There were 7 cases of type A,18 cases of type B and 8 cases of type C tumors in the present group.The tumors were surgically removed by using various approaches,i.e.transsphenoidal approach for type A,either transsphenoidal or transcranial approach for type B and transcranial approach for type C.Total tumor temoval was performed in 9 cases,subtotal or large part removal in 18 cases and partial removal in 6 cases.A brief discussion has been made on the choice of surgical approaches in pituitary macroadenomas.

关 键 词：垂体肿瘤 腺瘤 外科手术 手术入路 

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