论文部分内容阅读
目的:评价经鼻蝶窦显微手术治疗垂体腺瘤的疗效及并发症。方法:回顾性分析2005年7月至2012年7月间,在我科接受经鼻蝶窦显微手术治疗的144例垂体腺瘤患者的临床资料。术后复查鞍区增强MRI和血液内分泌激素,并门诊随访。结果:肿瘤全切共119例,次全切18例,部分切除7例,全切率82.6%。截至最后一次随访,临床症状消失76例,明显改善51例,改善不明显17例,临床症状缓解率88.2%。91例功能性垂体腺瘤,激素水平测定恢复正常率45.1%,明显改善率为86.1%。术后脑脊液鼻漏发生率为3.5%,垂体及靶腺激素功能低下发生率9.0%,一过性尿崩及电解质紊乱发生率为22.9%,颅内感染2例,无死亡病例。结论:经鼻蝶窦显微手术能有效地治疗垂体腺瘤,手术创伤及术后并发症少,是垂体腺瘤手术治疗的有效选择。
Objective: To evaluate the efficacy and complications of microsurgical treatment of pituitary adenoma by nasal sphenoid sinus surgery. Methods: The clinical data of 144 patients with pituitary adenoma undergoing microsurgical treatment of nasal sphenoid sinus in our department from July 2005 to July 2012 were retrospectively analyzed. Postoperative recanalization enhanced MRI and blood endocrine hormones, and out-patient follow-up. Results: A total of 119 cases of tumor resection, subtotal 18 cases, partial resection in 7 cases, total resection rate 82.6%. As of the last follow-up, clinical symptoms disappeared in 76 cases, 51 cases were significantly improved, 17 cases were not significantly improved, and the clinical symptom relief rate was 88.2%. 91 cases of functional pituitary adenomas, hormone levels returned to normal rate of 45.1%, a significant improvement rate of 86.1%. Postoperative cerebrospinal fluid rhinorrhea incidence was 3.5%, pituitary and target gonadotropin dysfunction incidence of 9.0%, transient insipidus and electrolyte imbalance occurred in 22.9%, 2 cases of intracranial infection, no deaths. Conclusion: Transnasal sinus surgery can effectively treat pituitary adenoma, surgical trauma and less postoperative complications, is an effective treatment for pituitary adenoma surgery.