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目的:探讨单鼻孔蝶窦入路显微手术治疗垂体腺瘤的技术方法和疗效。方法:对2002年12月至2005年1月44例垂体腺瘤患者采用经单鼻孔蝶窦直接入路显微手术技术予以切除。结果:27例(61.4%)患者腺瘤获全切除,13例(29.5%)次全切除,4例(9.1%)部分切除,无手术死亡。对33例(75%)患者进行平均14个月随访,20例(20/22)头痛消失或减轻;23例(23/25)视力、视野障碍显著改善,2例视力、视野障碍无改善;8例(8/10)肢端肥大症明显减轻;9例(9/12)溢乳停止;9例(9/14)月经恢复。结论:单鼻孔蝶窦入路显微外科手术最大限度地利用了鼻腔的自然间隙,具有入路直接、创伤轻微、手术时间短、并发症少等优点,是微创治疗垂体腺瘤的一种安全有效的方法。
Objective: To explore the technique and efficacy of microsurgical treatment of pituitary adenoma by single nostril sphenoid sinus approach. Methods: From December 2002 to January 2005, 44 patients with pituitary adenoma were treated by microsurgery via the single nostril sphenoid sinus approach. Results: Total adenomas were removed in 27 patients (61.4%), total excision in 13 patients (29.5%) and partial excision in 4 patients (9.1%). Thirty-three patients (75%) were followed up for an average of 14 months. Twenty (20/22) patients had headache disappeared or alleviated. The visual acuity and visual field were significantly improved in 23 patients (23/25) 8 cases (8/10) acromegaly significantly reduced; 9 cases (9/12) galactorrhea stopped; 9 cases (9/14) menstruation recovered. CONCLUSIONS: Single nostril sphenoid sinus microsurgery is a minimally invasive treatment of pituitary adenoma with microsurgery to maximize the natural space of the nasal cavity, which has the advantages of direct approach, minimal trauma, short operative time and few complications. Safe and effective method.