论文部分内容阅读
目的探讨采用扩大经蝶窦入路切除侵袭性垂体腺瘤的有效性和安全性。方法根据鞍区显微解剖学研究结果,采用扩大经蝶窦手术入路治疗64例侵袭性垂体腺瘤。结果肿瘤全部切除51例,次全切除13例。术后发生短暂性尿崩症26例,脑脊液鼻漏5例及急性腺垂体功能低下者1例,无死亡及颅内感染。8例患者术后给予放射治疗,6例予以溴隐亭治疗。随诊3个月至6年,未见肿瘤复发或继续生长。结论采用扩大经蝶窦入路切除巨大或不规则鞍外生长垂体腺瘤时,肿瘤显露满意,全切除率高,无明显手术并发症,是一种安全、有效的方法。对于那些肿瘤切除不彻底的患者,术后应密切随访,必要时给予放射或药物治疗。
Objective To explore the effectiveness and safety of expanding transsphenoidal approach for the removal of invasive pituitary adenomas. Methods According to the results of microscopic anatomy in the sellar region, 64 cases of invasive pituitary adenomas were treated by enlarged transsphenoidal approach. Results All tumors were resected in 51 cases and subtotal resections in 13 cases. Twenty-six cases of transient diabetes insipidus, five cases of cerebrospinal fluid rhinorrhea and one case of acute hypopituitarism without postoperative death and intracranial infection. Eight patients received radiotherapy postoperatively and 6 patients received bromocriptine treatment. Followed up for 3 months to 6 years, no tumor recurrence or continue to grow. Conclusions When expanding the transsphenoidal approach to excise pituitary adenomas with large or irregular saddle tumors, the tumor is satisfactory and has a high total resection rate without obvious complications. It is a safe and effective method. For those patients who have undergone incomplete tumor resection, follow-up should be performed after surgery and radiation or drug therapy should be given if necessary.