垂体腺瘤经单鼻孔内镜下切除  

Endoscopic endonasal transsphenoidal resection of pituitary adenomas

作　　者：周波[1] 周涛[2] 黄书岚[3] 刘仁忠[1] 晏丙元[1] 田道峰[1] 徐海涛[1] 

机构地区：[1]武汉大学人民医院神经外科,湖北武汉430060 [2]广州军区武汉总医院普通外科,湖北武汉430070 [3]武汉大学人民医院院长办公室,湖北武汉430060

出　　处：《中华神经外科疾病研究杂志》2003年第4期315-317,共3页Chinese Journal of Neurosurgical Disease Research

摘　　要：目的　总结我科经单鼻孔蝶窦入路内窥镜下切除垂体腺瘤 32例的手术经验。方法　经CT或MRI诊为垂体腺瘤的 32例患者 ,应用电视监测内窥镜经单鼻孔进入 ,术中不切除鼻中隔 ,直接打开蝶窦前壁 ,经鞍底切除垂体腺瘤。结果　全切除 2 6例 ,近全切除 6例。视力、视野均较术前有所恢复。 2例术后出现一过性脑脊液鼻漏 ,2例发生暂时性尿崩。术后 9例内分泌检查恢复正常 ,5例随访激素水平下降。结论　经蝶窦入路内窥镜下切除垂体腺瘤 ,具有手术时间短 ,创伤小 ,安全且并发症少等优点 。Objective To summarize our initial experience of endoscopic endonasal transsphenoidal surgery for pituitary adenomas. Methods From September 2000 to December 2002, 32 patients with pituitary adenoma were treated by endoscopic endonasal transsphenoidal pituitary adenoma surgery. Through transsphenoidal approach, no incision of the nasal mucosa was made. The nasal septum and median nasal conchae were not resected. Under endoscopic assistance, the anterior wall of the sphenoidal sinus and sellae floor were opened directly and adenoma resection was performed. Results All the patients were followed up for 1～12 months. By postoperative MRI scan, total removal of pituitary adenomas was achieved in 26 cases, subtotal removal was achieved in 6 cases. Rapid improvement of vision was noted postoperatively. The hormone level in 9 cases was normal postoperatively and improved in another 5 cases. Postoperative transient cerebrospinal fluid (CSF) leakage was found in 2 cases, transient diabetes insipidus in 2 cases. Conclusion The endoscopic endonasal transsphenoidal surgery for pituitray adenoma is safe, time-saving, and without severe complications. The injury to the patient and postoperative reaction are less. The application of the endoscopy for pituitary adenoma surgery is worthy of recommending.

关 键 词：垂体腺瘤 内镜 切除术 单鼻孔蝶窦入路 手术路径 

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