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目的探讨腰大池置管引流在垂体瘤切除术中的作用。方法 2008年5月至2011年1月收治69例垂体瘤患者,25例行经鼻-蝶入路垂体瘤切除术;44例行翼点入路垂体瘤切除术。术前均行腰大池置管引流,并持续引流5～7d。结果经鼻-蝶入路垂体瘤切除术全切肿瘤23例,次全切2例;翼点入路垂体瘤切除术全切肿瘤39例,次全切5例;2种手术入路合计肿瘤全切率达89.9%,未发生1例脑脊液漏及颅内感染。随访6个月,69例均无脑积水发生。结论术前行腰大池置管引流可降低颅内压,术中手术视野显露增大,术后引流血性脑脊液,减少蛛网膜粘连和脑积水的发生。
Objective To investigate the role of catheter drainage in pituitary tumor resection. Methods From May 2008 to January 2011, 69 patients with pituitary adenomas were treated, and 25 patients underwent transnasal-butterflies pituitary tumor resection. Forty-nine patients underwent pterional pituitary tumor resection. Preoperative lumbar drainage catheter placement and continuous drainage 5 ~ 7d. Results Twenty-three cases underwent resection of the pituitary tumor by nasal-buttotomy, 2 cases underwent subtotal resection, 39 cases underwent pituitary tumor excision, 5 cases underwent subtotal resection and 2 cases underwent total surgical approach Full rate of 89.9%, 1 case of cerebrospinal fluid leakage and intracranial infection did not occur. Six months follow-up, 69 cases had no hydrocephalus. Conclusion Preoperative drainage of the lumbar cistern can reduce the intracranial pressure, increase the visual field of operation, and induce the bloody cerebrospinal fluid after operation to reduce the incidence of arachnoid adhesions and hydrocephalus.