单鼻孔-蝶窦入路切除大型巨大型侵袭性垂体瘤61例  

Removing large and huge invasive pituitary adenoma by the single-nostril transsphenoidal approach

作　　者：袁苏涛[1] 杨波[1] 陈忠仪[1] 魏晨斌[1] 陈明武[1] 黄继仁[1] 陶剑[1] 余吉[1] 林伟[1] 魏德[1] 

机构地区：[1]福建省立医院福建医科大学省立临床学院神经外科,福建福州350001

出　　处：《中国耳鼻咽喉颅底外科杂志》2007年第4期259-261,共3页Chinese Journal of Otorhinolaryngology-skull Base Surgery

摘　　要：目的探讨大型、巨大型侵袭性垂体瘤经单鼻孔-蝶窦入路切除的手术方法及疗效。方法回顾性分析经单鼻孔-蝶窦入路切除61例大型、巨大型侵袭性垂体腺瘤患者的临床资料。结果全切32例,次全切20例,大部切除9例,无严重并发症及手术死亡病例。术后脑脊液鼻漏1例,卧床1周后痊愈;尿崩22例,均在术后2～3d出现,尿量5000～8000ml/d,1周5例,3～4周16例,最长半年1例,均采用垂体后叶素、尿崩停等治疗痊愈。术后视力视野均得到不同程度的改善,功能恢复。结论经单鼻孔-蝶窦入路手术加γ-刀治疗可作为大型、巨大型侵袭性垂体瘤的治疗方法。Objective To explore the method and via single-nostril transsphenoidal approach. Methods effect of removing large and huge invasive pituitary adenomas The clinical data of 61 patients with large and huge invasive pituitary adenomas surgically treated via the single-nostril transsphenoidal approach was analyzed retrospectively. Results Of all the cases, 32 received total resection of tumor, 20 received subtotal resection, and 9 received great part resection. No post-operative death and serious complications occurred. Cerebrospinal fluid rhinorrhea was observed in 1 case and got cured with bed rest for 1 week. Diabetes insipidus occurred in 22 cases 2 to 3 days after operation. Their daily urine volume ranged from 5000 ml to 8000ml. All the cases with diabetes insipidus were cured by use of hypophysin, minirin, insufflation posterior pituitary （5 cases within one week, 16 within 3 -4 weeks, and 1 within one year）. Visual acuity and visual field were ameliorated to different degrees and functions got recovered after operation. Conclusion Surgical treatment via single-nostril transsphenoidal approach combined with γ-knife therapy may be chosen for removing large and huge pituitary adenomas.

关 键 词：垂体肿瘤 腺瘤 侵袭性 经单鼻孔-蝶窦入路 显微外科手术 

分 类 号：R736.4[医药卫生—肿瘤]