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目的:探讨内镜下经鼻腔蝶窦入路垂体腺瘤显微手术方法。方法:在内镜下经鼻腔打开蝶窦前壁,暴露鞍底,在内镜下行垂体腺瘤切除术,并清除残余肿瘤。结果:腺瘤全切43例,次全切5例,大部切除3例。术后尿崩9例,头痛2例,无死亡、颅内感染、脑脊液漏、鼻中隔穿孔等并发症的发生。术后视力、视野、停经泌乳、激素水平均有不同程度的改善。结论:内镜视野方向多变、操作灵活,经内镜下鼻腔蝶窦入路垂体瘤切除术是一种创伤小,操作简便,治疗效果好的微侵袭神经外科技术。
Objective: To investigate the microsurgical methods of endoscopic transnasal sphenoid sinus pituitary adenoma. Methods: The anterior wall of sphenoid sinus was opened through the nasal cavity under endoscope, the sella was exposed, and underwent endoscopic resection of pituitary adenoma and the residual tumor was removed. Results: Total excision of 43 cases of adenomas, subtotal resection in 5 cases, most of the resection in 3 cases. Postoperative diabetes insipidus in 9 cases, headache in 2 cases, no death, intracranial infection, cerebrospinal fluid leakage, nasal septum perforation and other complications. Postoperative visual acuity, visual field, cessation of lactation, hormone levels have varying degrees of improvement. CONCLUSION: The direction of endoscopic visual field is varied and flexible. The endoscopic pituitary appendectomy is a kind of minimally invasive, simple and effective microinvasive neurosurgical technique.