69例垂体肿瘤经鼻蝶窦入路手术,采用鼻小柱“V”型切开,术中保留鼻中隔软骨,将取出的筛骨垂直板及部分犁状骨骨片作为修补鞍底之材料,余下部分仍复回原位,以保持正常生理解剖结构。对有出血倾向者于鞍底处置塑胶管引流。69例手术均取得满意的疗效,无严重并发症及死亡病例。笔者对该入路进行了有益的改进,同时对并发症的预防及肿瘤复发后再经此入路手术等问题进行了探讨。 69 cases of pituitary tumors were treated by transnasal sphenoid sinus surgery. The nasal column “V” was used for incision. Nasal septal cartilage was preserved during surgery. The removed vertical bone plate and part of plough bone were used as material for repairing saddle bottom. The remaining part is still back in place to maintain normal physiological anatomy. For those who have a tendency to bleed at the disposal of plastic tubes at the bottom of the saddle. 69 cases received satisfactory results without serious complications and deaths. The author made beneficial improvements to the approach, and discussed issues such as the prevention of complications and the recurrence of the tumor followed by this approach.