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本文报告一例经蝶窦垂体腺瘤切除并发颈内动脉海绵窦部假性动脉瘤。结合文献对其防治进行了讨论。女性患者,56岁。1987年2月因糖尿病视网膜性视力下降和肢端肥大而住院。查体:呈典型肢端肥大症。右眼视力仅有光感。左眼颞侧视野四分之一象限缺损。内分泌检查示生长激素(GH)增高。CT 扫描示蝶鞍扩大,肿瘤向鞍上发展。用改变的Hardy 氏法经蝶窦入路腺瘤摘除术。在鞍底开骨窗,切开硬膜时发生汹涌出血。怀疑损伤了颈内动脉海绵窦段。填塞止血,终止手术。术后病人情况同术前。术后和术后1周,分别行两侧颈内动脉造影,结果无异常。术后第八天经原入路取出填塞物,并做了巨大腺瘤肉眼全切除。术后右眼视力无变化,左眼视野缺损改善。平顺恢复后出院。两周后病人有过几次轻微鼻出血。第二次术后五周,因大量鼻
This article reports a case of transsphenoidal pituitary adenoma resection and internal carotid cavernous sinus pseudoaneurysm. Combining the literature discusses its prevention and control. Female patient, 56 years old. In February 1987, hospitalization was due to diabetic retinal vision loss and acromegaly. Physical examination: typical acromegaly. Right eye vision is only light perception. Left quadrant quadrant quadrant defect. Endocrine examination showed an increase in growth hormone (GH). A CT scan showed that the sella expanded and the tumor developed toward the saddle. Transsphenoidal adenoma removal with modified Hardy’s method. Burst bleeding occurred when the dura was cut at the open bottom of the saddle. It is suspected that the carotid cavernous sinus is damaged. Stop bleeding by stuffing and stop surgery. Postoperative patient conditions were the same as before surgery. Postoperatively and at 1 week after surgery, bilateral internal carotid arteriography was performed and no abnormalities were found. On the eighth day after surgery, the tamponade was removed through the original approach, and a giant adenoma was removed with a naked eye. There was no change in visual acuity in the right eye and improvement in visual field defect in the left eye. After smooth recovery, he was discharged. Two weeks later, the patient experienced several minor nosebleeds. The second time after five weeks, due to a large number of nose