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为探讨大型垂体腺瘤(LPA)经蝶入路、应用显微外科技术治疗的效果 ,作者对 15 2 0例LPA以颅骨X线平片、CT或MRI等影像学检查做出诊断 ,采取经蝶入路、显微镜下进行肿瘤切除术的病例进行了回顾性分析。结果表明 ,12 6 4例 (83 2 % )获全切除 ,195例(12 8% )达次全切除 ,余 6 1例 (4 0 % )系哑铃型或纤维性腺瘤 ,仅获部分切除。手术后 2例 (0 1% )死亡。 12 4 0例进行平均 3 5年随访观察 ,有 12 19例 (98 3% )视力损害获得了恢复 ,仅 2 1例 (1 7% )无变化 ,但未见恶化 ;术前有视野缺损的 12 2 6例 ,术后 1186例 (96 7% )明显改善 ,4 0例 (3 3% )无变化。作者认为 ,除了纤维性或哑铃状LPA外 ,对大型或巨大型垂体腺瘤采取经蝶入路显微外科手术切除是一种安全、有效的方法 ,可使视神经和视交叉获得迅速而充分的减压
To investigate the effect of microsurgical treatment of large pituitary adenoma (LPA) with transsphenoidal approach, the authors diagnosed 152 OLA radiographs using skull radiography, CT or MRI. Butterfly approach, under the microscope tumor resection cases were retrospectively analyzed. The results showed that 12 6 4 cases (83 2%) underwent total resection and 195 cases (12 8%) underwent total subtotal resection, while the remaining 61 cases (40%) were dumbbell-shaped or fibroadenomas and were only partially resected. Two patients (0 1%) died after surgery. Twelve hundred and forty cases were followed up for an average of 3-5 years. 12 19 (98.3%) had visual impairment and 21 cases (17%) had no change but no deterioration. 12,26 cases, 1186 cases (967%) were significantly improved, 40 cases (33%) did not change. The authors suggest that microsurgical resection of large or large pituitary adenomas in addition to fibrous or dumbbell-shaped LPA is a safe and effective method of transsphenoidal microsurgical removal of the optic nerve and optic chiasm to achieve rapid and adequate stress reliever