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目的:探讨经单鼻孔入路内神经窥镜下切除垂体瘤的方法及其优越性。方法:总结应用内窥镜直接经单鼻孔入路切除10例垂体瘤的初步经验。结果:10例患者均在内窥镜下行肿瘤全切除,其中8例视力下降患者术后24 h内明显恢复,术后1周复查血激素水平,2例垂体功能低下者恢复正常,另2例生长激素瘤患者和2例泌乳素瘤患者激素水平亦恢复正常。有3例出现尿崩症,经对症处理,2周后恢复;1例术中刮除鞍上肿瘤过程中鞍膈破裂,取自体脂肪粘EC胶填塞瘤腔,术后未发生脑脊液漏。结论:内窥镜下经单鼻孔入路垂体瘤切除术是一种安全、有效的微创方法,术者熟练掌握肿瘤的生物学特性和蝶鞍区局部解剖以及对内窥镜的灵活操控是手术成功的关键。
Objective: To explore the method and superiority of resecting pituitary tumor under single-nostril approach. Methods: To summarize the preliminary experience of endoscopic removal of 10 cases of pituitary adenomas by single nostril approach. Results: Totally 10 patients underwent endoscopic resection of the tumors. Eight patients with visual acuity recovered significantly within 24 h postoperatively. One week after operation, blood hormone levels were rechecked. Two patients with hypopituitarism returned to normal. Two patients The hormone levels in patients with growth hormone and 2 patients with prolactinoma also returned to normal. There were 3 cases of diabetes insipidus, symptomatic treatment, recovery after 2 weeks; 1 case of intraoperative saddle suprasellar calcaneal rupture of the tumor, taking from the body fat glue sticky EC glue cavity, no postoperative cerebrospinal fluid leakage. Conclusion: Endoscopic pituitary adenoma resection through a single nostril is a safe and effective minimally invasive method. The surgeon is familiar with the biological characteristics of the tumor and the local anatomy of the sella and the flexible manipulation of the endoscope The key to successful operation.