经鼻蝶显微手术治疗垂体腺瘤(附122例报告)  

Transsphenoidal Microsurgery for Pituitary Adenoma (Experiences of 122 cases)

作　　者：马大程[1] 周东[1] 黄辉 严琪 付学忠[1] 

机构地区：[1]北京铁路总医院神经外科,北京100038

出　　处：《中国临床神经外科杂志》2000年第3期154-156,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的 探讨垂体腺瘤经鼻蝶入路的指征和术中应注意的问题。方法 分析122例垂体腺瘤经鼻蝶显微外科治疗的情况。结果 微腺瘤32例,全切为31例(97％)。大腺瘤75例,全切51例(68％),其中鞍上20～30mm者22例,全切8例(36％)。巨大型腺瘤鞍上超过30mm者12例,仅4例全切。结论 垂体腺瘤鞍上部分超过20mm者经蝶手术不易全切,超过30mm应采用经额入路。视力极差者宜先经鼻蝶再经额两期手术。Objective To assess the indications of transsphenoidal approach in microsurgery for resection of the pituitary adenoma and to discuss the key points in the management of these patients. Methods A series of 122 cases of pituitary adenomas were treated by transsphenoidal microsurgery. Their clinical data were analyzed retrospectively. Results In 32 microadenoma cases, total resections of the tumors were achieved in 31 (97 %). There were 75 macroadenomas cases, of which 22 had suprasellar extension 20-30mm, and the total resection rate in these patients were 51/75(68%) and 8/22(36%) respectively. The total resections were achieved only in 4 out of 12 huge macroadenomas with suprasellar extension larger than 30mm. Conclusions It is not easy to achieve total resections in those patients with suprasellacr extension of the tumor larger than 20mm. If the diameter of the suprasellacr tumor exceeds 30mm, the transfrontal approach may be the first choice. For patients with severely damaged vision, it is better to decompress via transsphenoidal approach first, then to remove the residual tumor transfrontally by second stage.

关 键 词：垂体腺瘤 经鼻蝶入路 显微外科 治疗 

分 类 号：R736.405[医药卫生—肿瘤]