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目的总结神经内窥镜下经鼻蝶入路切除垂体腺瘤的手术经验并对其疗效进行评估。方法回顾性分析我院2007年1月-2011年3月期间行内窥镜经鼻蝶入路切除垂体腺瘤67例,对肿瘤切除程度以及术后并发症进行总结。结果垂体腺瘤67例,肿瘤全切47例,次全切19例,大部切除1例。术后视力好转46例,头痛减轻38例,月经紊乱好转6例。术后出现暂时性尿崩13例(19.4%,13/67);垂体功能低下8例(11.9%,8/67);视力减退4例(6%,4/67);脑脊液鼻漏4例(6%,4/67);顽固性低钠血症2例(3%,2/67);颅内感染3例(4.5%,3/67);瘤腔出血2例(3%,2/67);空蝶鞍1例(1.5%,1/67);嗅觉减退1例(1.5%,1/67);脑梗塞1例(1.5%,1/67)。无死亡病例。结论内镜下经鼻蝶入路切除垂体腺瘤是一种有效的微侵袭手术方法。
Objective To summarize the experience of surgical treatment of pituitary adenomas by transnasal approach under neuroendoscope and to evaluate its curative effect. Methods A retrospective analysis of 67 cases of pituitary adenoma was performed in our hospital from January 2007 to March 2011 with endoscopic transnasal approach. The resection degree and postoperative complications were summarized. Results Pituitary adenomas in 67 cases, 47 cases of total tumor resection, subtotal 19 cases, most of the resection in 1 case. Postoperative visual acuity improved in 46 cases, headache relief in 38 cases, 6 cases of menstrual disorders improved. There were 13 cases (19.4%, 13/67) of transient diabetes insipidus after operation, 8 cases (11.9%, 8/67) of pituitary dysfunction, 4 cases (6%, 4/67) of visual acuity, 4 cases of cerebrospinal fluid rhinorrhea (6%, 4/67); intractable hyponatremia in 2 cases (3%, 2/67); intracranial infection in 3 cases (4.5%, 3/67) / 67); 1 case of empty sella (1.5%, 1/67); 1 case of hyposmia (1.5%, 1/67); 1 case of cerebral infarction (1.5%, 1/67). No deaths. Conclusion Endoscopic transnasal approach for pituitary adenoma resection is an effective microinvasive surgical approach.