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目的 总结引起垂体肿瘤经颅手术死亡的重要因素 ,以降低术后死亡率。方法 用 L ogistic回归程序对 5 0 2例垂体肿瘤经颅手术患者进行回顾性分析。结果 5 0 2例全部经一侧额或翼点入路手术 ,术后死亡 2 1例 ,病死率 4.2 %。术后意识、术后体温、术中大出血、术后内环境、侵犯鞍区重要结构和肿瘤大小等 6项指标影响术后死亡 ,以前 4项为主。结论 统计结果与临床结果大致相符。在治疗中 ,应针对重要因素 ,进行充分而完善的术前准备 ,认真和审慎的手术方法 ,严密术后监测和及时的术后处理 ,可望将经颅手术的死亡率降低到经蝶手术水平
Objective To summarize the important factors causing the death of pituitary tumors by transcranial surgery in order to reduce postoperative mortality. Methods A retrospective analysis of 52 cases of pituitary tumors undergoing transcranial surgery was performed using logistic regression. RESULTS: A total of 520 patients were operated on one side of the forehead or pterional approach. 21 patients died after surgery, and the mortality rate was 4.2%. Postoperative mortality, including postoperative consciousness, postoperative body temperature, intraoperative hemorrhage, postoperative internal environment, invasion of important structures in the saddle area, and tumor size, affect the postoperative death. Conclusion The statistical results are generally consistent with the clinical results. In the treatment, adequate and complete preoperative preparation should be carried out according to important factors. Careful and prudent surgical methods, strict postoperative monitoring and timely postoperative treatment are expected to reduce the mortality rate of transcranial surgery to transsphenoidal surgery. Level