目的总结显微镜下单鼻腔经蝶垂体瘤微创手术的临床应用效果。方法回顾性分析136例显微镜下单鼻腔直接经蝶垂体瘤手术患者的临床资料。结果肿瘤全切124例,次全切除10例,大部分切除2例。术后内分泌功能恢复者61例,视力、视野恢复正常或有显著改善者29例。术后出现一过性尿崩者16例,难控制性尿崩者1例。术后3个月复查MRI发现肿瘤残余8例;其中,2例肿瘤呈侵袭性生长。无死亡及感染病例。结论显微镜下单鼻腔直接经蝶入路切除脑垂体瘤,具有手术创伤小、切除肿瘤相对完全、术后患者反应轻和恢复快的优点。 Objective To summarize the clinical effect of minimally invasive surgery of the single nasal transsphenoidal pituitary tumor under the microscope. Methods The clinical data of 136 patients undergoing single transsphenoidal pituitary tumor under the microscope were retrospectively analyzed. Results Totally 124 cases of tumor resection, subtotal resection in 10 cases, most of the resection in 2 cases. Postoperative endocrine function in 61 cases, vision, visual field returned to normal or significant improvement in 29 cases. There were 16 cases of transient atrophy after operation and 1 case of difficult control diabetes insipidus. Tumor recurrence was found in 8 cases 3 months after surgery, of which 8 cases showed aggressive growth. No deaths or infections. Conclusion Under the microscope, a single nasal approach to transsphenoidal pituitary adenoma resection of the pituitary tumor has the advantages of small trauma, complete resection of the tumor, mild postoperative reaction and rapid recovery.