目的观察二次经鼻蝶入路垂体瘤显微切除术的临床疗效。方法 30例既往经鼻蝶入路切除术垂体瘤患者,回顾其临床资料,并采取二次经鼻蝶入路垂体瘤显微切除术治疗,分析患者经手术的治疗效果。结果 30例患者中16例行全切除术,12例行次全切除术,2例患者行部分切除,无死亡病例。2例患者术后尿崩,症状较轻,经垂体后叶素得到控制;1例患者轻微脑脊液鼻漏,予以抗生素并取半坡卧位后痊愈。结论及时对残余垂体瘤患者采取二次经鼻蝶入路垂体瘤显微切除术,且要保证患者符合手术适应证情况,可明显提高患者治疗效果,安全有效,值得临床推广并使用。 Objective To observe the clinical effect of microsurgical resection of the second transsphenoidal pituitary tumor. Methods Thirty patients with past pituitary adenoma resection by nasal deltoid approach were retrospectively reviewed and treated with microsurgical resection of the pituitary tumor by nasal sphenonectomy. The therapeutic effect of the operation was analyzed. Results 16 of 30 patients underwent total resection and 12 underwent subtotal resection. Two patients underwent partial resection without any death. Two patients had postoperative diabetes insipidus. The symptoms were mild and controlled by pituitrin. One patient had mild cerebrospinal fluid rhinorrhea and was treated with antibiotics and recovered after being in half-down position. Conclusions Timely microscopic resection of the pituitary tumor by the second transsphenoidal approach in patients with residual pituitary adenoma should be performed promptly and the patient’s compliance with the surgical indications should be ensured. The therapeutic effect of the pituitary adenoma can be significantly improved, which is safe and effective. It is worthy of clinical promotion and use.