目的探讨大型、巨大型侵袭性垂体瘤经单鼻孔-蝶窦入路切除的手术方法及疗效。方法回顾性分析经单鼻孔-蝶窦入路切除61例大型、巨大型侵袭性垂体腺瘤患者的临床资料。结果全切32例,次全切20例,大部切除9例,无严重并发症及手术死亡病例。术后脑脊液鼻漏1例,卧床1周后痊愈;尿崩22例,均在术后2～3d出现,尿量5000～8000ml/d,1周5例,3～4周16例,最长半年1例,均采用垂体后叶素、尿崩停等治疗痊愈。术后视力视野均得到不同程度的改善,功能恢复。结论经单鼻孔-蝶窦入路手术加γ-刀治疗可作为大型、巨大型侵袭性垂体瘤的治疗方法。 Objective To investigate the surgical method and curative effect of large and huge invasive pituitary tumor by single nostril and sphenoid sinus approach. Methods The clinical data of 61 cases with large and giant invasive pituitary adenoma resected by single nostril - sphenoid sinus approach were retrospectively analyzed. Results Completely cut 32 cases, subtotal 20 cases, most of the 9 cases removed, no serious complications and surgical deaths. Postoperative cerebrospinal fluid rhinorrhea in 1 case, bed rest 1 week after cure; diabetes insipidus in 22 cases, were in 2 ~ 3d after surgery, urine output 5000 ~ 8000ml / d, 1 week in 5 cases, 3 to 4 weeks in 16 cases, the longest Six cases in a year, are used pituitrin, urinary collapse stop treatment cured. Postoperative visual field have been improved to varying degrees, functional recovery. Conclusion Single nostril - sphenoid sinus surgery plus γ-knife treatment can be used as a large, huge invasive pituitary tumor treatment.