CAJ | 학술논문

目的：探讨神经内镜下经鼻蝶入路治疗垂体腺瘤的手术疗效。方法：2012年1月至2012年12月，应用神经内镜经鼻蝶入路治疗垂体腺瘤25例，其中巨大腺瘤7例，大腺瘤18例；无功能腺瘤14例，垂体泌乳素（ PRL）腺瘤6例，生长激素（ GH）腺瘤3例， PRL＋GH腺瘤2例。术前均行头颅三维CT、MRI扫描及内分泌学检查。结果：本组25例，肿瘤全切除20例（80．0％），近全切除3例（12％），部分切除2例（8％）。术后尿崩3例，鼻出血1例。所有患者在术后第5～12天出院。术后随访1～10个月，患者临床症状和内分泌学指标均有所改善，未见肿瘤复发，无一例患者死亡。结论：神经内镜下经鼻蝶切除垂体腺瘤具有创伤小，术野清晰，手术操作简单、安全，术后并发症少，恢复快，住院时间短等优点，是治疗垂体腺瘤安全有效的手术方法。
목적：탐토신경내경하경비접입로치료수체선류적수술료효。방법：2012년1월지2012년12월，응용신경내경경비접입로치료수체선류25례，기중거대선류7례，대선류18례；무공능선류14례，수체비유소（ PRL）선류6례，생장격소（ GH）선류3례， PRL＋GH선류2례。술전균행두로삼유CT、MRI소묘급내분비학검사。결과：본조25례，종류전절제20례（80．0％），근전절제3례（12％），부분절제2례（8％）。술후뇨붕3례，비출혈1례。소유환자재술후제5～12천출원。술후수방1～10개월，환자림상증상화내분비학지표균유소개선，미견종류복발，무일례환자사망。결론：신경내경하경비접절제수체선류구유창상소，술야청석，수술조작간단、안전，술후병발증소，회복쾌，주원시간단등우점，시치료수체선류안전유효적수술방법。
Objective:To explore the technical aspects , effectiveness and morbidity of the neuroendo-scopic endonasal transphenoidal approach for pituitary adenomas .Methods:We retrospectively reviewed a se-ries of 25 patients(11 males and 14 females) with a diagnosis of pituitary adenomas after neuroendoscopic en-donasal transsphenoid resection in 2012.Among them, 7 had giant adenoma and 18 huge adenoma.Fourteen patients had non-functioning tumors , 5 had PRL-secreting tumors , 2 had GH-secreting tumors and 2 PRL+GH-secreting tumors.All the patients received neuroimaging (MRI and CT)and endocrinological examina-tions before surgery.Results:There was no surgical death.The tumor removal was total in 20(80%)cases,sub-total in 3(12%),and partial in 2(8%).Postoperative complications,including diabetes insipidus and epistax-is, occurred in 3 patients and 1 patient respectively .All patients achieved an improvement in clinical symptom after the operation.The hospital stay was 5-12 days.All cases were followed -up for1-10 months after opera-tion and no patients had a relapse .Conclusions:The neuroendoscopic endonasal transsphenoid surgery for pitui -tary adenomas has some obvious advantages such as minimal invasiveness ,clear exposure of operation field ,sim-ple operation,safety, patients quick recover , mild response and shorter hospitalization time .So the neuroendo-scopic endonasal transsphenoid surgery is a safe and effective approach for the treatment of pituitary adenomas .