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目的 探讨脑垂体腺瘤经鼻中隔蝶窦进路手术方法 ,并分析蝶窦解剖变异在术中可能发生的问题。方法 在全麻心肺监控下进行手术 ,术中遇解剖变异辨认困难时 ,用金属探针在手术台边摄头颅侧位 X线片定位 ;暴露鞍底硬脑膜时先穿刺抽吸无血液后始切开脑膜。结果 10例脑垂体腺瘤均顺利通过蝶窦进行切除 ,无手术并发症发生 ,术后症状改善 ,随访半年至 2年无复发。结论 经鼻中隔蝶窦入路切除脑垂体腺瘤 ,较开颅手术并发症少 ,死亡率低。如能严格选择适应症 ,此手术在县级医院开展是安全的
Objective To explore the transnasal sphenoid sinus approach for the treatment of pituitary adenomas and analyze the possible problems in the anatomic variations of sphenoid sinus surgery. Methods Underwent surgery under general anesthesia and cardiopulmonary monitoring. When the anatomical variation was difficult to identify in the operation, the metallographic probe was used to locate the cranial lateral radiograph at the operating table; when the saddle base dura was exposed, puncture and aspiration were needed before the blood. Cut the meninges. Results All 10 cases of pituitary adenoma were successfully removed through the sphenoid sinus without any complications. The postoperative symptoms were improved. There was no recurrence after 6 months to 2 years follow-up. Conclusion Transsphenoidal sinus approach for the removal of pituitary adenomas has fewer complications than craniotomy, and the mortality rate is low. If you can strictly select indications, this surgery is safe in county-level hospitals.