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本文报告了1981年6月～1985年3月间经蝶窦选择性切除垂体ACTH微腺瘤治疗28例Cushing病的经验,包括3例因蝶鞍环窦解剖学异常未能作垂体探查。25例作了垂体瘤切除术,取得良好效果。有效率为84％(21例),其中优良级17例(68％);减轻4例(16％),无效2例(8％),复发2例(8％)。无死亡.组织学发现垂体源ACTH腺瘤88％(22例)。本文还讨论了诊断、手术适应症、影响手术疗效的因素和手术并发症及其预防措施等。
This article reports the experience of transsphenoidal selective removal of pituitary ACTH microadenomas from June 1981 to March 1985 in 28 cases of Cushing’s disease, including 3 cases of pituitary exploration due to anatomical abnormalities of the sella sinus ring. Pituitary tumor resection was performed in 25 cases and good results were obtained. The effective rate was 84% (21 cases), of which 17 cases were excellent (68%); 4 cases (16%) were relieved, 2 cases (8%) were ineffective, and 2 cases (8%) were relapsed. No death. Histologically, pituitary ACTH adenomas were found in 88% (22 cases). This article also discusses the diagnosis, surgical indications, factors that affect the surgical outcome, surgical complications, and preventive measures.