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目的:探讨鼻内镜扩大经蝶窦入路切除巨大垂体腺瘤的可行性。方法:回顾性分析2000～2003年 间通过鼻内镜扩大经蝶手术入路治疗的13例巨大垂体腺瘤的临床资料。结果:所有患者术中镜下全部切除肿 瘤,术后10例患者给予放射治疗;术后影像学检查显示肿瘤有残余者6例,平均随访12个月肿瘤无复发或继续 生长。术后发生短暂性尿崩症6例,脑脊液鼻漏2例及急性腺垂体功能低下者1例;无死亡及颅内感染,无鼻腔 通气障碍、鼻腔粘连、鼻中隔穿孔等并发症。结论:扩大经蝶手术是治疗巨大垂体腺瘤的一种可行、安全、有效的 方法,但应掌握熟练的经蝶手术技术;术后应给予放射或药物辅助治疗。
Objective: To explore the feasibility of nasal endoscopy to expand transsphenoidal approach for giant pituitary adenoma. Methods: The clinical data of 13 cases of giant pituitary adenoma treated by enlarging transsphenoidal approach by endoscopic sinus surgery during 2000-2003 were retrospectively analyzed. Results: All patients underwent microsurgical resection of the tumor underwent microsurgery. Ten patients were given radiotherapy after surgery. Six patients with residual tumor were found by imaging examination after operation. The average follow-up of 12 months showed no recurrence or continued growth. Postoperative transient diabetes insipidus in 6 cases, 2 cases of cerebrospinal fluid rhinorrhea and acute hypopituitarism in 1 case; no death and intracranial infection, no nasal ventilation disorders, nasal adhesions, nasal septum perforation and other complications. CONCLUSION: Expanding transsphenoidal surgery is a feasible, safe and effective method for treating giant pituitary adenoma. However, skilled transsphenoidal surgery should be mastered. Radiation or drug-assisted therapy should be given after operation.