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本文介绍100例产生激素的垂体腺瘤经鼻、蝶窦显微手术的疗效。男34例,女66例。肢端肥大症42例,催乳素腺瘤47例(其中闭经-乳溢综合征36例),ACTH腺瘤11例。均采取经鼻中隔(保留骨、软骨、前鼻棘)蝶窦经路,包括选择性切除、大部切除、被膜下切除和连同底侧与海绵窦侧被膜在内的根治切除术,手术方式根据患者的年龄、性别和妊娠要求等因人而异。垂体腺瘤按其大小和伸展范围从5mm的微型瘤到5cm以上向颅前窝、颅中窝扩展阻塞第Ⅲ脑室引起脑水肿的巨大腺瘤,可分为五期。第一期肿瘤极小,境界清楚,有可能用选择切除法治愈。但临床上以瘤组织已充满蝶鞍的弥漫型腺
This article describes the efficacy of transnasal and sphenoid sinus microsurgery for 100 cases of hormone-producing pituitary adenomas. There were 34 males and 66 females. There were 42 cases of acromegaly, 47 cases of prolactinoma (36 cases of amenorrhea-acne syndrome), and 11 cases of ACTH adenoma. The transsphenoidal septal approach (retaining bone, cartilage, and anterior nasal spine) was adopted, including selective resection, subtotal resection, subcapsular resection, and radical resection including the basement side and cavernous sinus side capsules. The patient’s age, gender, and pregnancy requirements vary from person to person. Pituitary adenomas can be divided into five phases according to their size and extension range from 5mm microsurgical lesions to more than 5cm to the anterior cranial fossa and the middle cranial fossa. They can block the large adenoma that causes cerebral edema in the third ventricle. The first stage of the tumor is extremely small and the realm is clear. It may be cured by selective resection. But clinically, the tumor tissue is full of diffuse type glands of the sella.