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目的:探讨垂体腺瘤术后并发症发生的原因及预防措施。方法:回顾性分析328例垂体腺瘤术后发生并发症患者的临床资料。结果:经鼻蝶手术组6例,发生尿崩症1例,脑脊液漏2例,尿崩症合并脑脊液漏3例,脑脊液漏合并颅内感染1例;额下入路组10例,发生尿崩症7例,抽搐2例,鞍区血肿1例,脑室出血1例,垂体功能低下1例;翼点入路组16例,发生尿崩症10例,其中合并下丘脑损伤2例,低钠血症2例,其中合并消化道出血1例,全垂体功能减退4例。结论:肿瘤的大小与扩展方向决定垂体腺瘤不同术式的选择和术后并发的发生。
Objective: To investigate the causes and preventive measures of postoperative complications of pituitary adenoma. Methods: The clinical data of 328 patients with postoperative complications of pituitary adenoma were retrospectively analyzed. Results: In the transnasal surgery group, 6 cases developed diabetes insipidus, 2 cases of cerebrospinal fluid leakage, 3 cases of diabetes insipidus with cerebrospinal fluid leakage and 1 case of cerebrospinal fluid leakage and intracranial infection. In the inferior frontal approach group, 10 cases developed urinary 7 cases of insipidus, 2 cases of convulsions, 1 case of sella hematoma, 1 case of ventricular hemorrhage, 1 case of pituitary dysfunction; pterional approach group of 16 cases, diabetes insipidus occurred in 10 cases, including 2 cases of hypothalamic injury, low 2 cases of hyperlipidemia, including gastrointestinal bleeding in 1 case, all pituitary dysfunction in 4 cases. Conclusion: The size of the tumor and its direction of expansion determine the choice of different surgical procedures for pituitary adenomas and postoperative complications.