鼻内镜下垂体腺瘤切除术——附28例报告  

Endoscopic pituitary adenoma surgery-Report of 28 cases

作　　者：孙敬武[1] 王明善[1] 叶非常[1] 刘认华[1] 金自仓[1] 周全藩[1] 

机构地区：[1]合肥市安徽省立医院耳鼻咽喉科-头颈外科,230001

出　　处：《耳鼻咽喉（头颈外科）》2003年第2期71-73,共3页Chinese Arch Otolaryngology-Head Neck Surg

摘　　要：目的:探讨鼻内镜下垂体腺瘤手术的治疗经验。方法:鼻内镜下经鼻中隔-蝶窦、鼻内镜辅助经鼻中隔-蝶窦和经鼻腔-蝶窦三种入路手术行垂体腺瘤切除术,共28例。结果:Hardy-Wilson分级Ⅰ级者7例全切除;Ⅱ级者7例,5例全切除,2例次全切除;Ⅲ级者11例,5例全切除,5例次全切除,1例部分切除;Ⅳ级者3例,部分切除。严重并发症蛛网膜下腔出血1例,死亡1例。术后随访2个月～56个月,手术全切除17例中1例复发。结论:鼻内镜下垂体腺瘤手术克服了显微镜下不能观察蝶窦外侧壁重要血管和神经等结构的缺点,经鼻内镜垂体腺瘤切除术具有操作简单、到达蝶鞍比较容易、损伤小的优点,符合微创外科手术原则。Objective: The experience of the endoscopic surgery for the pituitary adenoma was reviewed. Methods: Twenty eight consecutive patients with pituitary adenoma were treated by surgery of endoscopy technique from May 1994 to June 2002. Among 28 patients, 15 were underwent standard transseptal and trans-sphenoid approach through columellar incision in which 11 cases were performed under endoscope alone, 4 with microscope combined endoscope. The later 13 patients were treated by transnasal and trans-sphenoid endoscopic surgery. Results: The pituitary adenomas of 17 patients were completely resected which included 12 microadenoma and 5 intrasellar macroadenoma. Later 11 patients were subtotal removed (7 cases) or larger partial removed (4 cases). In 28 cases, one died and one had subarachnoid hemorrhage. Conclusion; The endoscope technique provided distinct advantages over microscope in imaging intrasellar and parasellar structures during pituitary tumor resection, especially offers a superior view over the microscope of the suprasella region. The approach of transnasal transsphenoidal endoscopic technique is effective and less traumatic. Surgeons should be understand its feasibility, limits and indications.

关 键 词：鼻内镜 垂体腺瘤 肿瘤切除术 手术入路 微创外科 良性肿瘤 影像学检查 

分 类 号：R736.4[医药卫生—肿瘤] R730.56[医药卫生—临床医学]