经鼻蝶窦入路显微手术治疗垂体腺瘤疗效分析  

Treatment Effect Analysis of Transsphenoidal Microsurgery for Pituitay Adenoma

作　　者：范润金 任海波[1,2] 张逵 唐辉[1,2] 杨理媛 成华轩[1,2] 

机构地区：[1]南充市中心医院 [2]川北医学院第二临床医学院神经外科,四川南充637000

出　　处：《肿瘤预防与治疗》2013年第4期216-219,共4页Journal of Cancer Control And Treatment

摘　　要：目的:评价经鼻蝶窦显微手术治疗垂体腺瘤的疗效及并发症。方法:回顾性分析2005年7月至2012年7月间,在我科接受经鼻蝶窦显微手术治疗的144例垂体腺瘤患者的临床资料。术后复查鞍区增强MRI和血液内分泌激素,并门诊随访。结果:肿瘤全切共119例,次全切18例,部分切除7例,全切率82.6%。截至最后一次随访,临床症状消失76例,明显改善51例,改善不明显17例,临床症状缓解率88.2%。91例功能性垂体腺瘤,激素水平测定恢复正常率45.1%,明显改善率为86.1%。术后脑脊液鼻漏发生率为3.5%,垂体及靶腺激素功能低下发生率9.0%,一过性尿崩及电解质紊乱发生率为22.9%,颅内感染2例,无死亡病例。结论:经鼻蝶窦显微手术能有效地治疗垂体腺瘤,手术创伤及术后并发症少,是垂体腺瘤手术治疗的有效选择。Objective： To evaluate the curative effect and complications of transsphenoidal microsurgery for pituitay adenoma. Methods： Clinical data of 144 pituitary adenomas patients accepted transsphenoidal microsurgery in our department from July 2005 to July 2012 were retrospectively analyzed. Serial saddle area enhance MRI and blood endocrine hormone were checked for every patients after therapy, and all patients were followed up in sections for outpatients. Results：One hundred and nineteen cases accepted total re- section,18 cases underwent sub-total resection and 7 cases received most tumors resection, The rate of total resection was 82. 6%. Until the last follow-up, clinical symptoms disappeared in 76 cases, improved obviously in 51 cases, not obviously improved in 17 cases, the relieve rate of clinical symptoms was 88.2%. Among 91 cases with functional pituitary adenoma, the rate of hormone recovery and re- mission were 45. 1% and 86. 1%. The rate of postoperative CSF rhinorrhea, pituitary and target gland hormone function disorder, tran- sient diabetes insipidus and electrolyte disorder was 3.5% ,9. 0%, and 22.9%, respectively. Two cases had intraeranial infection. No deaths happened. Conclusion ：The transsphenoidal microsurgery can treat pituitary adenoma effectively with few surgical trauma and postoperative complications. It is a good choice for the surgical treatment for pituitary adenomas.

关 键 词：垂体腺瘤 显微外科 经鼻蝶窦手术 并发症 

分 类 号：R736.4[医药卫生—肿瘤]