经单鼻孔蝶窦入路切除垂体瘤:神经内镜和显微镜下比较研究  

Pituitary adenoma resection by the single-nostril transsphenoidal approach :comparative study on curative effects between neuroendoscope and microscope

作　　者：刘希光[1] 李爱民[1] 李宁[1] 夏咏本[1] 王富元[1] 孙维晔[1] 马逵[1] 

机构地区：[1]江苏省徐州医学院附属连云港医院神经外科,连云港222002

出　　处：《中国肿瘤临床与康复》2010年第3期262-265,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨显微镜和神经内镜下经单鼻孔蝶窦入路切除垂体瘤的临床应用和优缺点。方法对24例经CT扫描和MRI检查确诊为垂体瘤的患者在显微镜或神经内镜下经单鼻孔蝶窦入路直视下予以切除。结果显微镜组:10例全切除,2例大部分切除;内镜组:11例全切除,1例大部分切除。两组患者术后症状均有不同程度的改善,无严重并发症发生。结论内镜经鼻蝶垂体瘤手术中具有良好的深部照明及全景化的视野等优点,较显微镜下经单蝶入路切除垂体瘤的过程中更微创,提高了肿瘤的全切率,但两种术式都应该熟练掌握,根据不同的患者灵活地选择术式。Objective To investigate the clinical application of the single-nostril transsphenoidal approach by neuroendoscope and microscope to resection of pituitary adenomas.Methods Twenty-four patients with pituitary adenomas were diagnosed by CT or MRI.The adenomas were resected by endonasal-transsphenoidal surgery under neuroendoscope or microscope.Results Microscopy group： total removal of the tumors in 10 cases,partial removal in 2.Neuroendoscopic group： total removal of the tumors in 11 cases,partial removal in 1.The patients of both groups had varying degrees of improvement,without serious complications.Conclusion Endonasal-transsphenoidal surgery under neuroendoscope can provide an excellent exposure of the supra-and para-sella tumors and perfect surgery vision.Meanwhile it causes less trauma and increased the rate of total resection of tumor.However,both types of surgical procedures should be mastered,so that different surgical procedures could be chosen for different patients.

关 键 词：单鼻孔经蝶 垂体瘤 显微镜 神经内镜 

分 类 号：R736.4[医药卫生—肿瘤] R730.56[医药卫生—临床医学]