经鼻蝶入路内镜辅助垂体腺瘤切除手术24例  

Transsphenoidal endoscopic assisted resection of pituitary adenoma operation：report of 24 cases

作　　者：黄俊红[1] 叶党华[1] 桂志勇[1] 谭占国[1] 

机构地区：[1]漯河医学高等专科学校第一附属医院神经外科,河南漯河462000

出　　处：《中国实用医刊》2015年第19期33-34,共2页Chinese Journal of Practical Medicine

摘　　要：目的：分析经鼻蝶入路内镜辅助垂体腺瘤切除手术。方法选取从2013年4月至2014年3月漯河医学高等专科学校第一附属医院收治的垂体腺瘤患者24例,在内镜辅助下经鼻蝶入路行垂体腺瘤切除术。结果24例手术全部顺利完成,术后视力视野改善19例（79.17%,19/24）,无变化4例（16.67%,4/24）,恶化1例（4．17%,1/24）；恶化病例行二次经鼻蝶手术后好转。术后2周内内分泌激素均恢复正常。术后3个月对患者进行磁共振复查,未见肿瘤残余14例（58.33%,14/24）,见肿瘤残余10例（41.67%,10/24）,其中部分残余（残余＆lt;50%）4例（16.67%,4/24）,大部分残余（残余〉50%）6例（25.00%,6/24）。结论在垂体腺瘤切除手术中,内镜辅助下经鼻蝶入路具有较高的临床应用价值,具有以下特点：不需进颅,创伤小,在手术显微镜的帮助下可选择性切除肿瘤而对正常垂体组织损伤极小。Objective To analyze the transsphenoidal endoscopic assisted resection of pituitary adenoma opera-tion. Methods A total of 24 pituitary adenoma patients from 2013 April to 2014 March in our hospital received pituitary adenoma resection in endoscopic endonasal transsphenoidal approach. Results All cases successfully completed the opera-tion, 19 cases with visual improvement after operation （79. 17% , 19 / 24）, 4 cases without improvement （16. 67% , 4 / 24）, deteriorated in 1 cases （4. 17% , 1 / 24）;deterioration underwent two times of transsphenoidal operation after im-provement. After 2 weeks, endocrine hormones were normal. After treatment for three months, no residual tumor in 14 ca-ses （58. 33% , 14 / 24）,10 cases of residual tumors （41. 67% , 10 / 24）, 4 cases of partly residual （ residual〈 50% ） （16. 67% , 4 / 24）, more partly of the residual （residual 〉 50% ） in 6 cases （25% , 6 / 24）. Conclusions In the opera-tion for pituitary adenoma resection, the clinical application value of transsphenoidal approach is high, with the following characteristics： no need to enter the skull, small trauma, in operation microscope under the help of the selective resection of the tumor and the minimal normal pituitary tissue injury.

关 键 词：鼻蝶入路 内镜辅助 垂体腺瘤 

分 类 号：R739.4[医药卫生—肿瘤]