神经内镜手术切除侵袭型巨大垂体腺瘤七例体会  

Neuroendoscopic operation in treatment of giant invasive pituitary tumor： seven cases of experience

作　　者：姚冰[1] 朴浩哲[1] 张烨[1] 孙佩欣[1] 隋锐[1] 陈一[1] 郭旭[1] 

机构地区：[1]辽宁省肿瘤医院神经外科,沈阳110042

出　　处：《中国医师进修杂志》2013年第29期38-40,共3页Chinese Journal of Postgraduates of Medicine

基　　金：辽宁省社会发展攻关计划（2009225008-18）;沈旧市社会发展攻关计划（1091149-9-00）

摘　　要：目的探讨侵袭型巨大垂体腺瘤神经内镜手术适应证、手术切除过程中风险规避以及手术技巧。方法回顾性分析经鼻蝶神经内镜手术切除61例垂体腺瘤患者中7例侵袭型巨大垂体腺瘤患者的临床资料。结果全切除肿瘤1例，次全切除6例均侵袭海绵窦，其中5例切除肿瘤后均见鞍膈，2例未见鞍膈下落。手术时间平均100min。无术中输血患者。术后术区血肿2例，1例术后36h死亡，1例进行内镜下血肿切除术后痊愈。结论伴随神经内镜技术的发展，对于手术适应证的选择有了新的变化，对于侵袭型巨大垂体腺瘤的手术治疗，神经内镜技术为我们提供了一次性手术切除的可能，该方法是安全的，可以避免出现灾难性后果。Objective To study the giant invasive pituitary tumor neuroendoseopic operation indications, operation excision ,risk aversion, and the operation skills. Methods The clinical data of 7 patients with giant invasive pituitary tumor among of endoscopic transsphenoidal surgery 61 cases of neurological patients with pituitary tumors were analyzed retrospectively. Results There were 1 case of total resection, 6 cases of subtotal resection invading cavernous sinus cases, diaphragma sellar was seen in 5eases of resection of the tumor, and 2 cases showed no diaphragma sellar. The average operation time was 100 minutes. No intraoperative transfusion. Postoperative hemorrhage in 2 cases, and 1 death case in this group after 36 hours, and 1 case undergoing endoscopic hematoma resection and cured. Conclusions With the development of endoscopic techniques, indications for operation with the new changes, for the giant invasive pituitary tumor operation therapy, endoscopic technique provides a disposable operation resection, the method is safe and avoid catastrophic consequences.

关 键 词：神经内窥镜 巨大 垂体肿瘤 经蝶窦手术 

分 类 号：R739.4[医药卫生—肿瘤]