经蝶窦入路手术切除垂体腺瘤的严重并发症分析  

Retrospective study on major complications of transsphenoidal microsurgery in 1000 patients with pituitary adenoma

作　　者：杨众[1] 任祖渊[1] 苏长保[1] 王任直[1] 杨义[1] 马文斌[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院神经外科,北京100730

出　　处：《中国微侵袭神经外科杂志》2008年第3期107-109,共3页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：首都医学发展基金重点支持课题(2003-2015)

摘　　要：目的探讨经蝶切除垂体腺瘤术后主要严重并发症的发生率和原因,并提出防治措施。方法分析1000例经蝶手术切除垂体腺瘤病例的临床资料,并结合文献加以讨论。结果术后发生出血性并发症7例,永久性尿崩症9例,脑脊液鼻漏超过1个月而需行修补手术3例,脑膜炎8例,视力、视野恶化10例,第Ⅲ、Ⅴ、Ⅵ脑神经麻痹6例。本组死亡3例。结论垂体腺瘤经蝶手术与开颅手术相比,创伤小,恢复快,疗效好,并发症少,病死率低;但仍有一些并发症出现,且个别严重,必须引起重视。Objective To research the incidence and the causes of major severe postoperative complications after pituitary adenoma resection via transsphenoidal approach, and present the preventive and therapeutic measures. Methods Clinical data of 1000 patients undergoing transspbenoidal procedures for pituitary adenomas were analyzed, and the literatures were reviewed to evaluate the complications and their management. Results After surgery, hemorrhagic complication occurred in 7 cases, permanent diabetes insipidns in 9, CSF rhinorrbea lasting for more than 1 month and needing reoperation in 3, meningitis in 8, visual worsening in 8, and Ⅲ,Ⅴ,Ⅵ nerves palsies in 6. The mortality of the group was 0.3% （3 cases）. Conclusion Transspbenoidal operation is being increasingly used in the management of pituitary tumors, with low morbidity and mortality,nevertheless, its potentially serious complications should be recognized and managed effectively.

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]