经鼻蝶入路垂体瘤切除术后鼻腔并发症的分析及处置  

Clinical analysis and treatment of nasal complications after transsphenoidal pituitary adenomasectomy

作　　者：程友[1] 薛飞[1] 王天友[1] 季俊峰[1] 陈伟[1] 王志颐 许莉[1] 杭春华[2] 

机构地区：[1]南京军区南京总医院耳鼻咽喉头颈外科,江苏南京210002 [2]南京军区南京总医院神经外科,江苏南京210002

出　　处：《中国耳鼻咽喉头颈外科》2017年第9期475-478,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨经鼻蝶入路垂体瘤切除术后鼻腔并发症的防治方法。方法 129例患者行经鼻蝶入路垂体瘤切除术,统计术后发生鼻腔并发症患者,对其进行分析及处置。结果经鼻蝶入路垂体瘤切除术后发生鼻腔并发症者26例(20.1%),包括鼻出血6例(4.8%)、脑脊液鼻漏9例(6.9%)、蝶窦炎3例(2.3%)、萎缩性鼻炎2例(1.6%)、嗅觉障碍2例(1.6%)、鼻中隔穿孔1例(0.8%)、鼻腔粘连3例(2.3%)等。经鼻内镜下定期术腔清理、鼻用激素、鼻腔冲洗等治疗后疗效满意。结论对经鼻蝶入路垂体瘤切除术后并发鼻腔并发症患者应及时予以处置,可有效改善患者临床症状。OBJECTIVE To exlpore the prevention and therapy methods of nasal complications after transsphenoidal pituitary adenomasectomy. METHODS 129 cases of pituitary adenomas underwent transsphenoidal surgery. The postoperative nasal complications were observed and disposed. RESULTS A total of 26 cases（20.1%） of nasal complications appeared in all 129 cases of pituitary adenomas underwent transsphenoidal surgery, including nasal hemorrhage 6 cases（4.8%）, cerebrospinal fluid rhinorrhea 9 cases（6.9%）, sphenoid sinusitis 3 cases（2.3%）, atrophy rhinitis 2 cases（1.6%）, olfactory dysfunction 2 cases（1.6%）, nasal septum perforation 1 case（0.8%）, and nasal adhesion 3 cases（2.3%）. They were all cured after nasal endoscopic regular cavity clean, nasal hormone, nasal irrigation. CONCLUSION The nasal complications after transsphenoidal pituitary adenomas ectomy surgery should be timely disposed, which can effectively improve the patients＇ clinical symptoms.

关 键 词：垂体肿瘤 内窥镜检查 蝶窦 手术后并发症 鼻腔 

分 类 号：R736.4[医药卫生—肿瘤]