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目的探讨经单鼻孔蝶窦入路显微切除垂体瘤的手术方法及总结经验。方法选取滁州市第一人民医院26例垂体瘤患者(全部经单鼻孔蝶窦入路显微手术切除)的临床资料,对手术入路、术中操作、并发症的处理进行临床分析。结果 26例垂体腺瘤患者中,泌乳素(PRL)分泌性腺瘤10例;生长激素(GH)分泌性腺瘤6例;PRL和GH混合性腺瘤2例;非分泌性腺瘤8例,肿瘤全切18例,次全切除5例,大部分切除3例。发生电解质紊乱1例,暂时性尿崩症5例,无永久性尿崩症,脑脊液鼻漏2例,持续2周,无需再次手术。结论与开颅垂体瘤切除手术相比,经蝶窦入路手术明显降低了病死率和伤残率,是治疗垂体瘤的首选入路之一,严格把握好手术适应症和禁忌症,能使需要手术治疗的垂体瘤患者取得满意的治疗效果。
Objective To investigate the surgical methods and experience of microsurgical removal of pituitary tumors by single nostril sphenoid approach. Methods The clinical data of 26 patients with pituitary adenoma in First People ’s Hospital of Chuzhou City (all underwent microsurgical resection with single nostril sphenoid sinus approach) were selected for clinical analysis of surgical approach, intraoperative operation and complication. Results Among 26 patients with pituitary adenoma, 10 were secreting prolactin (PRL) adenoma, 6 were secreting adenocarcinoma of growth hormone (GH), 2 were PRL and GH mixed adenoma, 8 were non-secreting adenoma, 18 cases, subtotal resection in 5 cases, the majority of resection in 3 cases. Electrolyte disorder occurred in 1 case, 5 cases of temporary diabetes insipidus, no permanent diabetes insipidus, cerebrospinal fluid rhinorrhea in 2 cases, continued for 2 weeks, without reoperation. Conclusion Compared with craniotomy pituitary tumor resection, transsphenoidal surgery significantly reduced the mortality and disability rate is one of the first choice for the treatment of pituitary tumor, strict surgical indications and contraindications can enable Need for surgical treatment of pituitary tumor patients to obtain satisfactory treatment.