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目的研究向鞍旁扩张的垂体腺瘤手术入路的选择。方法垂体腺瘤患者84例,根据其影像学检查结果按照Knosp的方法进行分级,并对同一级别肿瘤经蝶与经颅两种手术入路在切除率、术后并发症以及随访等方面进行比较。结果经蝶手术对于Knosp3级以下的肿瘤的切除效果满意。而Knosp4级以上的肿瘤仍需经颅手术切除。结论经蝶手术适用于Knosp0~3级的垂体腺瘤患者;对于Knosp4级以上的垂体腺瘤患者仍需经颅手术切除。
Objective To study the choice of surgical approach to pituitary adenoma with parasellar extension. Methods Eighty-four patients with pituitary adenoma were classified according to the method of Knosp according to their imaging findings. The resection rate, postoperative complication and follow-up were compared between the two transesophageal and transcranial tumors . Results The transsphenoidal surgery was satisfactory for resection of tumors below Knosp3 level. Knosp4 tumors still require transcranial resection. Conclusion Transsphenoidal surgery is suitable for patients with pituitary adenomas of grade 0 ~ 3 of Knospas and transcranial resection of patients with pituitary adenomas of grade 4 or higher.