自体组织鞍底缝合技术在垂体腺瘤经鼻蝶入路神经内镜切除术后脑脊液漏修补中的应用  

Application of autologous tissue suture technique for sellar floor reconstruction for cerebrospinal fluid leakage in patients with pituitary adenoma after transsphenoidal neuroendoscopic resection via transsphenoidal approach

作　　者：丁崇学 高亮[1] 吴洁 周凯[1] 张庭荣[1] 李绍山[1] DING Chong-xue;GAO Liang;WU Jie;ZHOU Kai;ZHANG Ting-rong;LI Shao-shan(Departemnt of Neurosurgery,First Affiliated Hospital,Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院神经外科,乌鲁木齐830054

出　　处：《中国临床神经外科杂志》2024年第8期449-452,共4页Chinese Journal of Clinical Neurosurgery

基　　金：新疆维吾尔自治区自然科学基金(2022D01C244)。

摘　　要：目的探讨自体组织鞍底缝合技术在垂体腺瘤经鼻蝶入路神经内镜切除术后脑脊液漏修补中的安全性及有效性。方法回顾性分析2021年1月至2023年12月经鼻蝶窦入路神经内镜手术切除的21例垂体腺瘤的临床资料。结果21例术中开放鞍隔后均出现脑脊液漏,均采用自体组织鞍底硬膜缝合技术重建鞍底,术后均未出现脑脊液鼻漏。2例术后继发颅内感染,感染率为9.5%;1例术后1个月内发生鼻出血。术后随访3~21个月,平均(9.3±6.6)个月,未见脑脊液鼻漏。结论垂体腺瘤经鼻蝶窦入路神经内镜切除术中因开放鞍隔导致的脑脊液漏,术中采用自体组织修补加缝合术进行鞍底重建,可有效预防术后脑脊液鼻漏,且手术安全性良好。Objective To explore the safety and efficacy of autologous tissue suture technique for the sellar floor reconstruction for cerebrospinal fluid leakage in patients with pituitary adenoma after neuroendoscopic resection via transsphenoidal approach.Methods The clinical data of 21 patients with pituitary adenoma resected by neuroendoscopic transsphenoidal surgery via transsphenoidal approach from January 2021 to December 2023 were retrospectively analyzed.Results Cerebrospinal fluid leakage occurred in all 21 patients after opening the sellar diaphragm during the operation.The sellar floor was reconstructed by autologous tissue suture technique,and no cerebrospinal fluid rhinorrhea occurred after the operation.Two patients developed secondary intracranial infection after the operation,with an infection rate of 9.5%;one patient had epistaxis within one month after the operation.The postoperative follow-up period was 3~21 months,with an average of(9.3±6.6)months,and no cerebrospinal fluid rhinorrhea was observed.Conclusion For cerebrospinal fluid leakage caused by opening the sellar diaphragm during neuroendoscopic transsphenoidal resection of pituitary adenoma,the use of autologous tissue repair and suture technique for sellar floor reconstruction during the operation can effectively prevent postoperative cerebrospinal fluid rhinorrhea,and the surgical safety is good.

关 键 词：垂体腺瘤 经鼻蝶入路 神经内镜切除术 自体组织鞍底缝合技术 脑脊液漏 鞍底重建 

分 类 号：R739.41[医药卫生—肿瘤] R651.11[医药卫生—临床医学]