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目的:探讨手术治疗垂体腺窟的合理入路。方法:取15个标本作鞍区的显微解剖观察,回顾性分析113例垂体腺瘤手术的观察和经验教训,进行对照研究。结果:国人的鞍结节较平坦,间隙1容易采用。许多间隙2狭小,妨碍了外侧入路的展开,并且增加了视路并发症。经蝶入路提供了更好的肿瘤显露和治疗结果。结论:入路选择要强调个体化原则,虽然经单侧鼻腔入路最值得推崇,但额下入路不象以前评价的那么悲观,其中眶上锁孔入路前景良好,由于肿瘤形态的差异,向鞍旁显著扩展的肿瘤依然需要经翼点入路完成。
Objective: To explore the reasonable approach of surgical treatment of pituitary gland. Methods: Fifteen specimens were taken for anatomic observation in the saddle area. The clinical observation and experience of 113 cases of pituitary adenoma were retrospectively analyzed and compared. Results: Chinese saddle nodules more smooth, easy to use a gap 1. Many of the gaps 2 are narrow, obstructing the deployment of the lateral approach and increasing the visual pathway complications. The transsphenoidal approach provides better tumor exposure and treatment outcomes. Conclusion: The choice of pathways should emphasize the principle of individualization. Although the nasal approach is most worthy of praise, the inferior approach is not as pessimistic as the previous ones. The prospect of the supraorbital keyhole approach is good. Due to the differences in tumor morphology , The significant expansion of the saddle next to the tumor still need to be completed by the wing point approach.