论文部分内容阅读
目的探讨神经内镜下经鼻蝶入路垂体腺瘤手术切除的临床治疗效果。方法回顾分析上海交通大学医学院附属苏州九龙医院神经外科2011年7月~2013年8月收治的神经内镜下经鼻蝶入路垂体腺瘤手术切除的98例患者,其病理结果均为垂体腺瘤。手术前后分别行内分泌学检查,术后随访3个月,复查垂体MRI。结果肿瘤全切除率78.6%(77例),次全切除率16.3%(16例),部分切除率5.1%(5例)。术后视力、视野较术前明显改善者18例,激素水平较术前下降或完全恢复至正常者35例;发生脑脊液漏6例,其中4例经腰大池置管后治愈,另外2例行脑脊液鼻漏修补手术治愈,暂时性尿崩5例,高热及电解质紊乱2例,无死亡病例。术后平均住院时间5.5d。结论神经内镜下经鼻蝶入路切除垂体腺瘤是一种安全、微创、有效的治疗方式,术后并发症少,减轻患者痛苦,缩短患者的住院时间。
Objective To investigate the clinical effect of endoscopic pituitary adenomas undergoing endoscopic transnasal approach. Methods A retrospective analysis of 98 patients with neurosurgery undergoing endoscopic transnasal pituitary adenoma surgical resection admitted to Department of Neurosurgery, Suzhou Kowloon Hospital, Shanghai Jiaotong University School of Medicine from July 2011 to August 2013 was performed. The pathological results were pituitary Adenoma. Before and after surgery were endocrinological examination, follow-up 3 months after surgery, review of pituitary MRI. Results Total resection rate was 78.6% (77 cases), subtotal resection rate was 16.3% (16 cases), partial resection rate was 5.1% (5 cases). Postoperative visual acuity, visual field compared with preoperative significantly improved in 18 cases, hormone levels decreased compared with preoperative or fully recovered to 35 cases; occurred in 6 cases of cerebrospinal fluid leakage, of which 4 cases were cured by lumbar cistern catheterization, the other 2 cases Cerebrospinal fluid rhinorrhea repair surgery cured, temporary diaphragmatic in 5 cases, fever and electrolyte disorders in 2 cases, no deaths. The average postoperative hospital stay was 5.5 days. Conclusions Endoscopic transnasal approach for pituitary adenoma resection is a safe, minimally invasive and effective method of treatment. The postoperative complications are less, the pain of patients is reduced, and the hospitalization time of patients is shortened.