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目的:探讨经单鼻孔-蝶窦入路显微手术切除垂体腺瘤的科学性和实用技术技巧。方法:报告手术治疗42例大型、巨大型腺瘤,分析所遇到的问题和手术技术改进过程,结合文献讨论技术要点。结果:肿瘤全切除32例,次全切除4例,大部切除5例,部分切除1例。85.7%出现术后尿崩,个别出现迟发性鼻腔出血。结论:经单鼻孔入路属于新型的徽创手术,虽然通道狭小,但只要操作适当,不论鼻孔大小如何均可安全实施该手术,但要注意鼻腔的止血和定位的准确性。
Objective: To explore the scientific and practical skills of microsurgery for pituitary adenomas via single nostril - sphenoid sinus approach. Methods: Forty - two cases of giant adenoma were surgically treated. The problems encountered and the improvement of surgical technique were analyzed. The main points of the article were discussed. Results: Tumor resection in 32 cases, subtotal resection in 4 cases, partial resection in 5 cases, partial resection in 1 case. 85.7% postoperative diabetes insipidus, individual delayed onset of nasal bleeding. CONCLUSIONS: The single nostril approach is a new type of invasive surgery. Although the access is narrow, as long as the operation is proper, the operation can be safely performed regardless of the size of the nostrils. However, the hemostasis of the nasal cavity and the accuracy of positioning should be paid attention to.