经鼻-蝶入路治疗垂体瘤的术后常见并发症及处理策略  

Measures against common complications in patients with pituitary adenomas treated by transphenoidal microsurgical approach

作　　者：夏大勇 江晓春 戴易 刘策刚 赖年升 赵晨辉 刘佳强 徐善水 XIA Dayong;JIANG Xiaochun;DAI Yi;LIU Cegang;LAI Niansheng;ZHAO Chenhui;LIU Jiaqiang;XU Shanshui(Department of Neurosurgery,The First Affiliated Hospital of Wannan Medical College,Wuhu 241001,China)

机构地区：[1]皖南医学院第一附属医院弋矶山医院神经外科

出　　处：《皖南医学院学报》2019年第4期330-332,共3页Journal of Wannan Medical College

基　　金：国家自然科学基金项目(81701357);安徽省高校自然科学研究重点项目(KJ2018A0253);弋矶山医院引进人才科研基金项目(YR201911)

摘　　要：目的:探讨显微镜辅助下经鼻-蝶入路治疗垂体瘤的术后常见并发症及处理策略。方法:选取74例经鼻-蝶入路垂体瘤显微切除术患者,对术后出现的并发症和处理措施进行总结与分析。结果:术后出现脑脊液漏1例(1.35%),尿崩症10例(13.51%),垂体功能低下22例(29.72%)及电解质紊乱8例(10.81%);所有并发症采取积极有效的治疗后均好转,无死亡病例。微小腺瘤、大腺瘤和巨大腺瘤组患者脑脊液漏、尿崩症、激素水平低下、电解质紊乱及其他并发症的发生率差异无统计学意义(P>0.05)。结论:经鼻-蝶垂体瘤显微切除术具有创伤小、手术时间短、恢复快等优点,对术后常见的并发症应采取积极有效的治疗策略,提高患者预后。Objective: To investigate the common complications and the countermeasures to manage the complications in patients with pituitary adenomas treated by tansphenoidal microsurgical approach. Methods :Case data were collected from 74 patients of pituitary adenomas treated by transphenoidal microsurgical approach,and analyzed regarding the common complications following surgery and measures to managed such complications. Results :Common complications following transpheoidal microsurgery were associated with leakage of crebrospinal fluid in one case(1.35%),temporary diabetes insipidus in 10(13.51 %),hypopituitarism in 22(29.72%) and electrolyte disturbance in 8(10.81%).All complications were reversed by targeted aggressive treatment.No death occurred.The complications described above remained insignificant in different size of pituitary adenomas( P> 0.05). Conclusion :Transphenoidal microsurgical approach can be minimally invasive,shorter operative time and early recovery for patients of pituitary adenomas.Although some complications are involved in such surgical modality,yet the prognosis can be good if the complications are timely and aggressively managed.

关 键 词：垂体腺瘤 脑脊液漏 尿崩症 垂体功能低下 电解质紊乱 

分 类 号：R736.4[医药卫生—肿瘤]