基层医学论坛
基層醫學論罈
기층의학론단
PUBLIC MEDICAL FORUM MAGAZINE
2015年
4期
446-448
,共3页
垂体瘤%神经内镜%微创手术%鼻-蝶入路
垂體瘤%神經內鏡%微創手術%鼻-蝶入路
수체류%신경내경%미창수술%비-접입로
Pituitary adenoma%Nerve endoscopy%Minimally invasive surgery%Nostril-transsphenoidal approach
目的:研究神经内镜下经双鼻孔-蝶窦入路切除垂体瘤的手术优势。方法神经内镜辅助下经双鼻孔-蝶窦入路切除垂体瘤51例,回顾性分析患者的临床资料,总结手术疗效。结果肿瘤全切除38例(74.5%),近全切除11例(21.5%),部分切除2例(3.9%)。术后发生脑脊液漏3例(5.8%),暂时性尿崩症17例,经积极处理后均治愈。术后3个月随访无死亡病例及严重后遗症,手术时间为30 min~180 min,平均约81.4 min。随访3个月~12个月,平均6个月,原有症状均有不同程度改善。结论神经内镜经双鼻孔-蝶窦入路切除垂体瘤是一种创伤小、安全有效的治疗方法,随着术者手术技巧的熟练和经验的提高、内镜配套器械的完善,以及Surgical止血纱布等新型材料的应用,其临床应用必定会越来越广泛。
目的:研究神經內鏡下經雙鼻孔-蝶竇入路切除垂體瘤的手術優勢。方法神經內鏡輔助下經雙鼻孔-蝶竇入路切除垂體瘤51例,迴顧性分析患者的臨床資料,總結手術療效。結果腫瘤全切除38例(74.5%),近全切除11例(21.5%),部分切除2例(3.9%)。術後髮生腦脊液漏3例(5.8%),暫時性尿崩癥17例,經積極處理後均治愈。術後3箇月隨訪無死亡病例及嚴重後遺癥,手術時間為30 min~180 min,平均約81.4 min。隨訪3箇月~12箇月,平均6箇月,原有癥狀均有不同程度改善。結論神經內鏡經雙鼻孔-蝶竇入路切除垂體瘤是一種創傷小、安全有效的治療方法,隨著術者手術技巧的熟練和經驗的提高、內鏡配套器械的完善,以及Surgical止血紗佈等新型材料的應用,其臨床應用必定會越來越廣汎。
목적:연구신경내경하경쌍비공-접두입로절제수체류적수술우세。방법신경내경보조하경쌍비공-접두입로절제수체류51례,회고성분석환자적림상자료,총결수술료효。결과종류전절제38례(74.5%),근전절제11례(21.5%),부분절제2례(3.9%)。술후발생뇌척액루3례(5.8%),잠시성뇨붕증17례,경적겁처리후균치유。술후3개월수방무사망병례급엄중후유증,수술시간위30 min~180 min,평균약81.4 min。수방3개월~12개월,평균6개월,원유증상균유불동정도개선。결론신경내경경쌍비공-접두입로절제수체류시일충창상소、안전유효적치료방법,수착술자수술기교적숙련화경험적제고、내경배투기계적완선,이급Surgical지혈사포등신형재료적응용,기림상응용필정회월래월엄범。
ObjectiveTo study the operation advantage of the Treatment of pituitary adenoma via double nostril-transsphenoidal approach by neuroendoscopy.MethodsTreatment of pituitary adenoma via double nostril-transsphenoidal approach by neuroendoscopy 51 cases,a retrospective analysis of clinical data of patients, summarize the effects of the operations.Resultsthe tumor removal was total in 38 cases(74.5%),subtotal in 11 cases (21.5%),partial in 2 cases(3.9%). Nasal cerebrospinal fluid leaks,occurred in 3 cases(5.8%),temporary diabetes insipidus in 17 cases(33.3%),after active treatment were cured. Review of head MRI and preoperative imaging was compared,March follow-up,no deaths and serious sequelae,operation time is 30-180 minutes,average 81.4 minutes. Patients were followed up for 3 ~ 12 months,average 6 months,most symptoms were improved.Conclusiont Treatment of pituitary adenoma via double nostril-transsphenoidal approach by neuroendoscopy is a minimally invasive,safe and effective,with the improvement of operation skills of skill and experience to improve,endoscopic matching apparatus, and the application of surgical gauze for hemostasis,Treatment of pituitary adenoma via double nostril-transsphenoidal approach by neuroendoscopy will be more widely spread.