经蝶垂体腺瘤手术并发症  

Complications of transsphenoidal surgery for pituitary adenomas

作　　者：魏少波[1] 张纪[1] 周定标[1] 许百男[1] 张远征[1] 余新光[1] 

机构地区：[1]中国人民解放军总医院神经外科,北京100853

出　　处：《中国微侵袭神经外科杂志》2006年第6期241-243,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的分析经蝶入路切除垂体腺瘤的手术并发症。方法回顾性分析1980年3月￣2005年9月我科2 103例经蝶手术的垂体腺瘤病人术后并发症。结果尿崩症发生率为18.1%,低钠血症3.6%,视力恶化1.7%,垂体功能低下2.0%,中枢神经损伤1.0%,眼肌麻痹1.5%,脑脊液鼻漏2.2%,颈动脉损伤0.8%,鼻衄0.2%,严重蛛网膜下腔出血0.3%,残瘤出血或肿胀0.4%,脑膜炎0.4%,病死率0.8%。结论熟悉手术局部解剖,把握手术适应证,熟练掌握手术技能、不断总结临床实践经验,才能降低手术并发症和病死率,提高治疗效果。Obje ctive To analyze the complications of transsphenoidal operation for pituitary adenomas. Methods Postoperative complications of 2103 patients underwent transphenoidal surgery for pituitary adenoma between March 1980 and September 2005 in our department were retrospectively reviewed. Results Insipidus was the most common complication after the operation with the incidence of 18.1%, hyponatremia was the second one with the incidence of 3.6%. The other significant complications were visual deterioration （1.7%）, anterior pituitary insufficiency （2.0%）, central nervous system injury （1.0%）, ophthalmoplegia （1.5%）, cerebrospinal fluid rhinorrhea （2.2%）, carotid artery injuries （0.8%）, epistaxis （0.2%）, severe subarachnoid hemorrhage （0.3%）, hemorrhage or swelling of residual tumor （0.4%）, meningitis （0.4%）. The case fatality rate was 0.8%. Conclusions Better understanding of the indications for transsphenoidal surgery and familiarity with the regional anatomy should further lower the rates of death and complications. Skill surgical technique and clinical experience are also very important to improve the therapeutic efficacy.

关 键 词：垂体肿瘤 经蝶手术 手术后并发症 

分 类 号：R736.4[医药卫生—肿瘤]