中华神经医学杂志
中華神經醫學雜誌
중화신경의학잡지
CHINESE JOURNAL OF NEUROMEDICINE
2010年
8期
799-802
,共4页
垂体肿瘤%经鼻蝶入路%鼻内镜
垂體腫瘤%經鼻蝶入路%鼻內鏡
수체종류%경비접입로%비내경
Pituitary adenoma%Transsphenoidal approach%Nasalendoscope
目的 探讨经鼻蝶入路内镜下切除垂体腺瘤的手术技巧和适应证. 方法 南方医科大学珠江医院耳鼻咽喉头颈外科白2000年1月至2008年1月采用经鼻蝶入路内镜下肿瘤切除术治疗垂体腺瘤患者39例,其中非功能性腺瘤2例,功能性腺瘤37例,回顾性分析患者的临床资料、手术效果及相关并发症. 结果 37例功能性腺瘤全部切除(94.9%),2例非功能性腺瘤(Ⅴ期)因瘤组织侵犯鞍旁,术野操作受限术中未能全部切除(5.1%),患者于术后一个月行局部放射治疗,术后3年仍带瘤生存;术后48h内出现一过性多尿或尿崩者11例,脑脊液鼻漏者2例,均经治疗后痊愈;随访发现1例非功能性腺瘤患者存在单颞侧视野缺损,头痛症状完全消失或减轻16例(88.9%),泌乳症状减轻或消失11例(91.7%),视力恢复17例(100%),性功能好转7例(77.8%).37例功能性腺瘤患者激素水平均较术前明显好转或恢复正常. 结论 经鼻蝶人路内镜下切除垂体腺瘤具有简便、安全、微创的优点,只要正确地掌握好此类手术的适应证,在完整切除瘤体的前提下,能有效避免并发症,获得满意的治疗效果.
目的 探討經鼻蝶入路內鏡下切除垂體腺瘤的手術技巧和適應證. 方法 南方醫科大學珠江醫院耳鼻嚥喉頭頸外科白2000年1月至2008年1月採用經鼻蝶入路內鏡下腫瘤切除術治療垂體腺瘤患者39例,其中非功能性腺瘤2例,功能性腺瘤37例,迴顧性分析患者的臨床資料、手術效果及相關併髮癥. 結果 37例功能性腺瘤全部切除(94.9%),2例非功能性腺瘤(Ⅴ期)因瘤組織侵犯鞍徬,術野操作受限術中未能全部切除(5.1%),患者于術後一箇月行跼部放射治療,術後3年仍帶瘤生存;術後48h內齣現一過性多尿或尿崩者11例,腦脊液鼻漏者2例,均經治療後痊愈;隨訪髮現1例非功能性腺瘤患者存在單顳側視野缺損,頭痛癥狀完全消失或減輕16例(88.9%),泌乳癥狀減輕或消失11例(91.7%),視力恢複17例(100%),性功能好轉7例(77.8%).37例功能性腺瘤患者激素水平均較術前明顯好轉或恢複正常. 結論 經鼻蝶人路內鏡下切除垂體腺瘤具有簡便、安全、微創的優點,隻要正確地掌握好此類手術的適應證,在完整切除瘤體的前提下,能有效避免併髮癥,穫得滿意的治療效果.
목적 탐토경비접입로내경하절제수체선류적수술기교화괄응증. 방법 남방의과대학주강의원이비인후두경외과백2000년1월지2008년1월채용경비접입로내경하종류절제술치료수체선류환자39례,기중비공능성선류2례,공능성선류37례,회고성분석환자적림상자료、수술효과급상관병발증. 결과 37례공능성선류전부절제(94.9%),2례비공능성선류(Ⅴ기)인류조직침범안방,술야조작수한술중미능전부절제(5.1%),환자우술후일개월행국부방사치료,술후3년잉대류생존;술후48h내출현일과성다뇨혹뇨붕자11례,뇌척액비루자2례,균경치료후전유;수방발현1례비공능성선류환자존재단섭측시야결손,두통증상완전소실혹감경16례(88.9%),비유증상감경혹소실11례(91.7%),시력회복17례(100%),성공능호전7례(77.8%).37례공능성선류환자격소수평균교술전명현호전혹회복정상. 결론 경비접인로내경하절제수체선류구유간편、안전、미창적우점,지요정학지장악호차류수술적괄응증,재완정절제류체적전제하,능유효피면병발증,획득만의적치료효과.
Objective To evaluate the indications and the surgical technique of endoscopic transsphenoidal approach in the surgical treatment of pituitary adenomas. Methods We retrospectively analyzed the surgical effectiveness and complications of transsphenoidal approach under endoscope in treating 39 patients suffering from pituitary adenomas, including 37 with functional adenomas and 2 with non-functional adenomas. Results In all the patients with functional adenomas,tumors were totally resected. The 2 patients with non-functional adenoma invaded the seller obtained partial resection, and thus, postoperative radiotherapy was performed and preoperative symptoms were improved. All patients had no serious complications. All cases were followed up for 6-36 months: 1 had temporally visual loss; 11 appeared transient polyuria or diabetes insipidus; 2 developed cerebrospinal rhinorrhea, and they were cured after the treatment; headache was disappeared or relieved in 11, and sexual function got improvement in 7; the high preoperative PRL level was decreased to normal value in 37 patients after the surgery. Conclusion Endoscopic transsphenoidal technique, a safe, minimally invasive and efficient procedure for removing pituitary adenomas, offers simple and rapid access to the sella turcica and also provide direct visualization, thus improving the surgeon's ability to resect the tumors.
