CAJ | 학술논문

目的探讨经单鼻孔-蝶窦入路切除垂体腺瘤术中脑脊液鼻漏的预防措施.方法回顾性分析北京军区总医院附属八一脑科医院自2000年2月至2013年10月经单鼻孔-蝶窦入路进行垂体腺瘤切除术的464例患者的临床资料,评估脑脊液鼻漏发生的原因及预后.结果发生脑脊液鼻漏共31例,切除肿瘤导致脑脊液漏者19例,术中随瘤顶脱落发生鞍膈破损者7例,肿瘤溢出过快导致脑脊液漏者1例,切开硬膜位置不当导致脑脊液漏者3例,误穿刺鞍膈者1例.全部病例经术中、术后处置均获治愈,无再次手术.结论根据术前影像特点,手术中精确、适度切开鞍底骨质及硬膜,注意肿瘤切除的技巧可预防脑脊液鼻漏的发生.
목적 탐토경단비공-접두입로절제수체선류술중뇌척액비루적예방조시.방법 회고성분석북경군구총의원부속팔일뇌과의원자2000년2월지2013년10월경단비공-접두입로진행수체선류절제술적464례환자적림상자료,평고뇌척액비루발생적원인급예후.결과 발생뇌척액비루공31례,절제종류도치뇌척액루자19례,술중수류정탈락발생안격파손자7례,종류일출과쾌도치뇌척액루자1례,절개경막위치불당도치뇌척액루자3례,오천자안격자1례.전부병례경술중、술후처치균획치유,무재차수술.결론 근거술전영상특점,수술중정학、괄도절개안저골질급경막,주의종류절제적기교가예방뇌척액비루적발생.
Objective To discuss the prevention of cerebrospinal fluid rhinorrhea during mononostril-transsphenoidal operation of pituitary adenomas.Methods Four hundred and sixty-four patients with pituitary adenomas,admitted to our hospital from February 2000 to October 2013 and operated by mononostril-transsphenoidal approach,were chosen in our study; their clinical data,surgical methods and effects were retrospectively analyzed,and the reasons of cerebrospinal fluid rhinorrhea and their prognoses were evaluated.Results Cerebrospinal fluid rhinorrhea occurred in 31 patients,19 of them caused by tumor removal management and seven caused by damage of diaphragma sellae following tumor falling off,one duo to fast slipping off the tumor and 3 due to incorrect resection of the bone and (or) dura in the base of the sella.All patients were cured by management during and after the operations,without second surgery.Conclusion According to the pre-operative CT or MR images of the tumors,precise judgment and resection of the bone and(or) dura in the base of the sella and removal of the tumors with prompt procedure may prevent the occurrence of cerebrospinal fluid rhinorrhea.