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【目的】探讨垂体腺瘤在单纯内镜下单鼻腔经蝶窦入路切除的临床疗效。【方法】对24例垂体腺瘤患者在硬性鼻内镜控制下经单鼻腔进入,不切除鼻中隔直接经蝶窦入路切除垂体腺瘤,其中无功能腺瘤14例,泌乳素腺瘤9例,生长激素腺瘤1例。【结果】24例患者中,肿瘤全切21例,近全切3例。术后4例一过性脑脊液漏,1例暂时性尿崩。死亡1例。随访6个月至2年,10例患者内分泌功能均恢复正常,复发1例,无鼻中隔穿孔、萎缩性鼻炎和唇龈麻木等并发症。【结论】内镜下单鼻腔经蝶窦入路手术切除垂体腺瘤,入路途径短,切除腺瘤彻底,鼻腔结构损伤小,手术显露良好,具有明显优越性。
【Objective】 To investigate the clinical effect of pituitary adenoma resection by single nasal transsphenoidal approach under simple endoscopy. 【Methods】 Twenty-four patients with pituitary adenomas underwent single nasal cavity under the control of rigid endoscopic sinus surgery. Pituitary adenoma was excised directly through the sphenoid sinus without resection of the nasal septum. There were 14 cases of non-functioning adenomas and 9 cases of prolactinomas , 1 case of growth hormone adenoma. 【Results】 Among the 24 patients, 21 cases were completely resected and 3 cases were resected. Postoperative 4 cases of transient cerebrospinal fluid leakage, 1 case of transient diabetes insipidus. 1 case of death. All cases were followed up for 6 months to 2 years. The endocrine function of 10 patients returned to normal with one case of recurrence without complications of nasal septum perforation, atrophic rhinitis and labial numbness. 【Conclusions】 Endoscopic single-nasal transsphenoidal surgery for pituitary adenoma resection has short pathways, complete removal of adenomas, minimal damage to nasal structures and good surgical findings. It has obvious advantages.