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目的 :探讨内窥镜技术在直接经鼻蝶垂体腺瘤切除术中的应用。方法 :2 0 0 0年 3月～2 0 0 0年 8月在 1 3例直接经鼻蝶垂体腺瘤切除术中应用内窥镜技术 ,其中垂体微腺瘤 3例、大腺瘤 1 0例。内窥镜直接由单鼻孔进入 ,8例在鼻前庭作切口、 5例未作鼻腔皮肤粘膜切口 ,内窥镜下显露蝶窦开口 ,打开蝶窦 ,经鞍底切除肿瘤。结果 :1 3例患者随访 1个月～ 5个月 ,平均 3个月。术前 1 0例内分泌检查异常患者术后复查激素水平均降至正常 ;MRI术前、后对照 ,1 0例肿瘤全部切除 ,3例在海绵窦残余部分肿瘤。术后发生暂时性尿崩症 3例、 1例发生脑脊液鼻漏 ,经二次手术修补治愈。结论 :在直接经鼻蝶垂体腺瘤手术中应用内窥镜技术有利于良好显露术野和彻底切除肿瘤 ,疗效满意 ,并发症少 ,值得进一步推广。
Objective: To explore the application of endoscopic techniques in the direct transsphenoidal pituitary adenoma resection. Methods: From March 2000 to August 2000, endoscopic techniques were used in the removal of axillary pituitary adenomas in 13 patients. Among them, 3 were pituitary microadenomas and 10 were large adenomas. example. The endoscope was directly accessed through a single nostril. Eight patients had an incision at the nasal vestibule and five had no incisions on the skin and mucous membranes of the nasal cavity. Under the endoscope, the sphenoid sinus opening was revealed, the sphenoid sinus was opened, and the tumor was removed by the sella. Results: A total of 13 patients were followed up from 1 month to 5 months, with an average of 3 months. Before surgery, 10 cases of abnormal endocrine examination patients after surgery, hormone levels decreased to normal; MRI before and after the control, 10 cases of all tumor resection, 3 cases of residual tumor in the cavernous sinus. Three cases of temporary diabetes insipidus and one case of cerebrospinal fluid rhinorrhea occurred after surgery and were cured by second surgery. Conclusion : The application of endoscopic technique in the direct transnasal pituitary adenoma surgery is conducive to the well-revealed operative field and the complete removal of the tumor with satisfactory results and fewer complications. It is worth further promotion.