CAJ | 학술논문

目的探讨和评价全神经内镜下经鼻蝶入路切除垂体瘤的手术技巧及临床应用价值.方法 2009年1月至2012年3月,完成72例单纯神经内镜经鼻-蝶垂体瘤切除术,回顾性分析患者术前、术后症状及激素水平变化、影像学资料、手术资料、并发症、随访资料等. 结果 72例病例中非功能性腺瘤22例(30.6％),泌乳素腺瘤24例(33.3％),生长激素腺瘤7例(9.7％),促肾上腺皮质激素腺瘤5例(6.9％),促甲状腺激素腺瘤1例(1.4％),多分泌性腺瘤13例(18.1％)；肿瘤全切除56例(77.8％),次全切除13例(18.0％),部分切除3例(4.2％)；并发脑脊液漏5例,出现短暂性尿崩6例.术后随访3 ～ 24个月,大部分功能性腺瘤术后激素基本恢复正常水平,术后1例视力变差,其余患者症状亦基本恢复正常. 结论全神经内镜经鼻蝶手术切除垂体腺瘤是一项安全、微创、有效的方法,具有全程直视下切除肿瘤的优点,但系统、专业的训练及相应的设备是必不可少的.
목적 탐토화평개전신경내경하경비접입로절제수체류적수술기교급림상응용개치.방법 2009년1월지2012년3월,완성72례단순신경내경경비-접수체류절제술,회고성분석환자술전、술후증상급격소수평변화、영상학자료、수술자료、병발증、수방자료등. 결과 72례병례중비공능성선류22례(30.6％),비유소선류24례(33.3％),생장격소선류7례(9.7％),촉신상선피질격소선류5례(6.9％),촉갑상선격소선류1례(1.4％),다분비성선류13례(18.1％)；종류전절제56례(77.8％),차전절제13례(18.0％),부분절제3례(4.2％)；병발뇌척액루5례,출현단잠성뇨붕6례.술후수방3 ～ 24개월,대부분공능성선류술후격소기본회복정상수평,술후1례시력변차,기여환자증상역기본회복정상. 결론 전신경내경경비접수술절제수체선류시일항안전、미창、유효적방법,구유전정직시하절제종류적우점,단계통、전업적훈련급상응적설비시필불가소적.
Objective To investigate and evaluate the clinical value of full endoscopic transnasal transphenoidal approach for the surgery of pituitary adenomas.Methods Seventy-two patients,who underwent full endoscopic transnasal transphenoidal approach for the surgery of pituitary adenomas,were selected from the Medical Center of Pituitary Adenomas of our hospital from January 2009 to March 2012.To retrospectively investigate pre- and post-operation symptoms,hormone levels,images information,operation information,complications,following-up information and so on.Results Among the 72 consecutive patients,there were 22 nonfunctioning adenomas,twenty-four prolactin secreting adenomas,seven somatotropin secreting adenomas,five adrenocorticotropic hormone secreting adenomas,one thyrotropin secreting adenomas,and 13 multi-secreting adenomas.The tumor removal was total in 56(77.8％),subtotal 13(18.0％),and partial 3(4.2％).Five cases had CSF leaks,and 6 diabetes insipidus.After 3-24 months of follow-up,the levels of increasing-hormone declined to normal levels in most patients.Conclusion Full endoscopic transnasal transphenoidal approach for the surgery of pituitary adenomas is a kind of technique which is safe,minimally invasive,having less complications and fast recovery.However,it is necessary for surgeons to accept systematic and specialized training,and own advanced equipments.