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目的 探讨颅咽管瘤手术中垂体柄的辨认与保护方法及其对预后的影响。方法 对63例颅咽管瘤病人垂体柄的影像学和术中表现进行分析。结果 术中明确发现垂体柄33例,位于肿瘤瘤体后方23例、上方5例、侧方3例、前方2例。23例可在影像学上初步判断垂体柄与肿瘤的位置关系,均得到术中证实。垂体柄得到辨认与保护者术后尿崩的恢复好于术中未见垂体柄者。结论 垂体柄的辨认与保护对提高肿瘤全切除率、改善预后至关重要,MRI扫描可以为术中主动寻找及保护垂体柄提供帮助。
Objective To investigate the identification and protection of pituitary stalk in craniopharyngioma surgery and its influence on prognosis. Methods The imaging and intraoperative findings of pituitary stalk in 63 cases of craniopharyngioma were analyzed. Results The pituitary stalk was found in 33 cases, 23 in the posterior part of tumor, 5 in the upper part, 3 in the lateral part and 2 in the anterior part. Twenty-three cases were able to initially determine the relationship between the pituitary stalk and the tumor on the basis of imaging and were confirmed intraoperatively. Pituitary stalk was identified and protector of postoperative diabetes insomnia recovery is better than those who did not see pituitary stalk surgery. Conclusion The identification and protection of pituitary stalk is very important to improve the total resection rate and improve the prognosis of the tumor. MRI scan can help find and protect pituitary stalk actively.