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目的分析和探讨垂体瘤经蝶切除时大出血的处理。方法5例术后病理证实为垂体瘤的病例,女4例,男1例。平均年龄33.2岁。平均病程27.3个月。二次手术者4例,放射治疗者3例,首次就诊者1例。均采用鼻蝶入路显微镜下切除瘤体,术中出现大出血,棉片-明胶海绵-棉片压迫,抽出棉片,8号双腔导尿管置入肿瘤腔,压迫止血、引流。根据引流量的多少,择时拔出引流管。结果随诊半年至4.5年,3例头痛、5例垂体功能障碍、3例视神经功能障碍症状明显改善,1例术后单眼全盲。结论垂体瘤经蝶显微外科手术时,采用以上方法,止血效果好,缓解症状,是治疗垂体瘤经蝶手术时大出血的有效方法。
Objective To analyze and discuss the treatment of bleeding after pituitary tumor resection. Methods 5 cases of pathologically confirmed pituitary tumor cases, 4 females, 1 males. The average age is 33.2 years old. The average duration of 27.3 months. 4 cases of secondary surgery, radiotherapy in 3 cases, the first visit in 1 case. Neoplasms were removed using a microscope under the microscope, bleeding occurred during surgery, cotton - gelatin sponge - cotton compression, out of cotton, 8 double lumen catheter into the tumor cavity, oppression to stop bleeding and drainage. According to the amount of drainage, timing drainage tube pulled out. Results Six months to 4.5 years of follow-up, 3 cases of headache, 5 cases of pituitary dysfunction, 3 cases of optic nerve dysfunction symptoms were significantly improved, 1 case of monocular blindness. Conclusion pituitary tumor microsurgery surgery, the use of the above method, hemostatic effect, relieve symptoms, is an effective treatment for bleeding pituitary tumor during transsphenoidal surgery.