单鼻孔蝶窦入路治疗老年人垂体腺瘤  

Trans-single nostril-sphenoidal approach for pituitary adenomas in aged patients

作　　者：杨伟文[1] 陈兵[1] 赵革灵[1] 

机构地区：[1]广东医学院附属医院神经外科,湛江524001

出　　处：《中华神经医学杂志》2006年第6期611-614,共4页Chinese Journal of Neuromedicine

摘　　要：目的探讨经单鼻孔蝶窦入路显微手术切除老年人垂体腺瘤的手术方法和疗效以及并发症的围手术期处理。方法回顾性分析我科在1995年1月～2005年12月采用本法治疗老年人垂体腺瘤54例,其中大腺瘤23例,巨大腺瘤31例。31例伴有垂体功能低下,经病理和内分泌学检查证实垂体PRL腺瘤18例,GH腺瘤5例,ACTH腺瘤7例,多分泌功能细胞腺瘤3例,无功能腺瘤21例。结果本组肿瘤全切除23例,次全切除20例,大部分切除11例。随访0．5～7．5年,治愈27例,缓解21例,复发3例,死亡1例,失访2例。结论本手术方法能最大限度地保护脑功能、创伤小、手术并发症少、术后恢复快、住院时间短,特别适宜治疗老年人垂体腺瘤。Objective To discuss the surgical techniques and curative effect of the microsurgical resection of pituitary adenamas via single nostril-sphenoidal approach in the aged patients and the treatment of the complications. Methods A series of 54 aged patients with pituitary adenomas （23 macroadenomas and 31 giant adenomas） were treated by microsurgery via single nostril-sphenoidal approach from January 1995 to December 2005. Of them, 31 cases had hypopituitarism. Pathological classification and endocrine examination demonstrated PRL adenoma in 18 cases, GH adenoma in 5, ACTH adenoma in 7, multifunctional adenoma in 3, nonfunctional adenoma in 21. Results In this group, total removal was achieved in 23, subtotal removal in 20 and partial removal in 11. During the follow-up of 0.5-7.5 years, 27 cases were cured, 21 had a remission, 3 relapsed, 1 died and 2 missed the follow-up. Conclusion This approach is especially suitable for pituitary adenomas in the aged patients because of protection of brain function, minimal invasion, few complications, quick postoperative recovery and short in-hospital time.

关 键 词：老年人 垂体腺瘤 经鼻-蝶入路 显微外科手术 

分 类 号：R736.4[医药卫生—肿瘤]