CAJ | 학술논문

目的探讨单纯使用神经内镜照明下经鼻蝶入路切除垂体大腺瘤的方法及应用价值.方法 2011年7月-2014年5月,对78例垂体大腺瘤在单纯使用神经内镜照明下经右侧单鼻孔-蝶窦入路进行手术切除.术中主要使用磨钻磨除同侧蝶窦前壁及鞍底骨质,分别使用0°和30°内镜进行瘤腔内瘤体切除. 结果 78例患者中全切除垂体腺瘤62例(79.49％),次全切除12例(15.38％),大部分切除3例(3.85％),部分切除1例(1.28％).其中71例术后获得了2个月～2年的随访,瘤体未见复发;49例头痛症状消失;47例视力均有不同程度改善;12例月经恢复;21例肢端肥大症患者面容及手脚均有不同程度地缩小.激素水平复查PRL恢复正常32例,GH恢复正常21例,ACTH恢复正常2例. 结论经鼻内镜垂体瘤切除术是一个简便、安全、微创的外科技术.随着内镜器械的不断更新,其操作灵活性和舒适度不断改善,内镜下经鼻蝶切除垂体腺瘤必将得到更广泛的开展.
목적 탐토단순사용신경내경조명하경비접입로절제수체대선류적방법급응용개치.방법 2011년7월-2014년5월,대78례수체대선류재단순사용신경내경조명하경우측단비공-접두입로진행수술절제.술중주요사용마찬마제동측접두전벽급안저골질,분별사용0°화30°내경진행류강내류체절제. 결과 78례환자중전절제수체선류62례(79.49％),차전절제12례(15.38％),대부분절제3례(3.85％),부분절제1례(1.28％).기중71례술후획득료2개월～2년적수방,류체미견복발;49례두통증상소실;47례시력균유불동정도개선;12례월경회복;21례지단비대증환자면용급수각균유불동정도지축소.격소수평복사PRL회복정상32례,GH회복정상21례,ACTH회복정상2례. 결론 경비내경수체류절제술시일개간편、안전、미창적외과기술.수착내경기계적불단경신,기조작령활성화서괄도불단개선,내경하경비접절제수체선류필장득도경엄범적개전.
Objective To summarize the experience of the simple neuroendoscopic endonasal transsphenoidal surgery for the large pituitary adenoma and discuss it's application value.Methods Seventy-eight cases of the large pituitary adenoma treated by simple neuroendoscopic endonasal transsphenoidal surgery from July,2011 to May,2014 were analyzed retrospectively.Tumors were resected using 0 and 30 degree endoscope after opening the same side of the anterior wall of the sphenoidal sinus and sellar bone using the abrasive drilling during operation.Results The tumor removal was total in 62 (79.49％),subtotal in 12 (15.38％),major in 3(3.85％) and part in 1 (1.28％).Seventy-one cases were followed up for 2 months to 2 years after operation and no recurrence was founded,the symptoms of headache disappeared in 49 cases;The vision of patients was improved in 47 cases,menstruation resumed in 12 cases;The acromegaly of patients reduced in 21 cases.Hormone level review of PRL returned to normal in 32 cases,GH returned to normal in 21 cases,ACTH returned to normal in 2 cases.Conclusion The endoscopic transsphenoidal surgery for large pituitary tumors is the safely,minimally invasive surgical techniques.With the development of endoscopic equipment constantly updated and the operational flexibility and comfort is improved ceaselessly,endoscopic transsphenoidal surgery for the sellar tumor will be carried out more widely.