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目的:了解内窥镜下经鼻入路切除垂体瘤的局部应用解剖,探讨内镜下经鼻蝶入路切除垂体瘤方法和临床意义。方法:在研究内镜下经鼻蝶入路切除的局部解剖的基础上,对本组30例经影像学和内分泌学检查诊断为垂体瘤的病人,行内镜下垂体瘤的切除术。结果:本组30例病人经影像学和内分泌学检查,全切除18例,大部分切除12例,术后尿崩10例,经治疗短期均治愈,术后头痛头昏症状均消失,视力改善9例,月经紊乱、向心性肥胖、多尿多饮等症状均有所改善,视力下降1例,无脑脊液漏。结论:经内镜下鼻蝶入路尽可能减少手术的损伤并保持鼻腔的完整性,在减少手术死角的基础上比较满意的切除垂体瘤,并缩短住院时间,但必须严格训练熟练掌握手术技巧。
Objective: To understand the application of endoscopic nasal resection of pituitary tumor local anatomy, to explore the endoscopic transnasal approach to remove pituitary tumor and its clinical significance. Methods: Based on the study of the local anatomy of endoscopic transsphenoidal approach, 30 cases of pituitary tumors diagnosed by imaging and endocrinology were treated with endoscopic pituitary tumor resection. Results: The group of 30 patients by imaging and endocrinology examination, 18 cases of total resection, most of the resection in 12 cases, 10 cases of postoperative diabetes insipidus, after a short period of treatment were cured, postoperative headache dizziness symptoms disappeared, visual acuity 9 cases, menstrual disorders, central obesity, polyuria and other symptoms have improved, vision loss in 1 case, no cerebrospinal fluid leakage. CONCLUSIONS: Endoscopic transnasal approach minimizes surgical damage and maintains nasal integrity. It is more satisfactory for the removal of pituitary tumors and shorter hospital stay based on the reduction of operative dead angle. However, surgical techniques must be rigorously trained and mastered .