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目的:探讨根据CT或MRI资料修正翼点入路显微手术切除侵袭性垂体腺瘤的优越性及手术效果。方法:根据术前影像学显示的肿瘤偏离中线方向和侵袭部位,修改翼点入路切口,应用显微技术切除56例侵袭性垂体瘤。术后常规CT或MRI检查,结合术后症状改善情况及随访后变化,判断治疗效果。结果:全切46例(82.1%),大部切除8例,部分切除2例。无死亡病例。随访6个月~6年,视力、视野好转46例(82.1%),无变化6例(10.8%),恶化4例(7.1%)。结论:根据术前影像学资料,科学地修正翼点入路切口,有助于肿瘤的显露及切除,可提高全切率,降低死亡及复发率。
OBJECTIVE: To investigate the superiority and surgical outcome of microsurgery for invasive pituitary adenoma modified by pterional approach based on CT or MRI data. Methods: According to the preoperative imaging, the tumor was deviated from the midline and the invasion site. The pterional approach incision was modified, and 56 cases of invasive pituitary adenoma were excised with microscopy. Postoperative routine CT or MRI examination, combined with postoperative symptoms and follow-up changes to determine the therapeutic effect. Results: 46 cases (82.1%) were completely resected, 8 cases were mostly resected, and 2 cases were partially resected. No deaths. The follow-up ranged from 6 months to 6 years. The visual acuity and visual field improved in 46 cases (82.1%), no change in 6 cases (10.8%) and deterioration in 4 cases (7.1%). Conclusion: According to the preoperative imaging data, sciatic incision can be corrected scientifically to reveal and resect the tumor. It can increase the full rate and reduce the rate of death and relapse.