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为探讨何种手术入路适合何种类型的垂体腺瘤,对557例各种垂体腺瘤采用经颅、经蝶入路手术。结果表明,经颅手术332例中,死亡3例,死亡率是0.9%,经蝶入路225例中死亡4例。死亡率是1.78%。经颅手术发生下丘脑功能紊乱7例,脑出血6例,脑脊液鼻漏2例;经蝶手术后发生下丘脑功能紊乱1例,颅内出血1例,脑脊液鼻漏5例,鼻出血2例。经颅术后随访300例无1例复发,经蝶术后随访204例,5例复发。结论:鞍内垂体腺瘤适合经蝶入路;大型、巨大型肿瘤适合经颅手术。
In order to investigate which surgical approach suits the type of pituitary adenoma, 557 cases of pituitary adenomas were treated with transcranial and transsphenoidal approach. The results showed that in 332 cases of transcranial surgery, 3 cases died, the mortality rate was 0.9%, and 4 cases died of transsphenoidal approach in 225 cases. The mortality rate was 1.78%. Transcranial surgery occurred in 7 cases of hypothalamic dysfunction, 6 cases of cerebral hemorrhage, 2 cases of cerebrospinal fluid rhinorrhea, 1 case of hypothalamic dysfunction, 1 case of intracranial hemorrhage, 5 cases of cerebrospinal fluid rhinorrhea, and 2 cases of epistaxis. No recurrence was found in 300 patients who were followed up after transcranial surgery. 204 patients were followed up after transsphenoidal surgery and 5 patients relapsed. Conclusion: Pituitary adenomas in the saddle are suitable for transsphenoidal approach; large, giant tumors are suitable for transcranial surgery.