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目的采取经单鼻孔-蝶窦路径于神经内窥镜下摘除垂体腺瘤(pituitary adenoma,PA),并评价其临床效果。方法本组215例PA,术前对患者作CT或MRI检查,显示肿瘤的大小及与周边结构的关系。均应用经单鼻孔-蝶窦路径、在神经内窥镜辅助下切除肿瘤。结果190例(88.4%)肿瘤获全切除,17例(7.9%)达次全切除,余8例(3.7%)为纤维性肿瘤仅达部分切除。术后死亡2例(0.9%)。对182例进行随访,平均3.5个月,其中165例垂体大腺瘤(pituitary macroadenoma,PMaA)者,150例(90.9%)视力和视野缺损迅速恢复,余15例(9.1%)亦有好转;17例垂体微腺瘤(pituitary microadenoma,PMiA)的内分泌功能障碍逐渐恢复。结论于神经内窥镜下经单鼻孔-蝶窦路径切除PA,是一种安全、有效的微侵袭手术方法。
Objective To investigate the clinical effect of pituitary adenoma (PA) under the neuroendoscope through the single nostril-sphenoid sinus pathways. Methods 215 cases of PA in this group, preoperative CT or MRI examination of patients showed the size of the tumor and the relationship with the surrounding structure. All applications are via single nostril - sphenoid pathways, with the aid of neuroendocrine tumors. Results Totally 190 cases (88.4%) had complete resection and 17 cases (7.9%) had complete subtotal resection. The remaining 8 cases (3.7%) were only partial resection of fibroids. Postoperative death in 2 cases (0.9%). A total of 182 patients were followed up for an average of 3.5 months. Among 165 cases with pituitary macroadenoma (PMaA), 150 cases (90.9%) had rapid visual acuity and visual field defect, and 15 cases (9.1%) also recovered. 17 cases of pituitary microadenoma (pituitary microadenoma, PMiA) endocrine dysfunction gradually restored. Conclusion It is a safe and effective method for microinvasive surgery for PA removal through single nostril-sphenoid sinus pathways under neuroendoscopy.