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目的 探讨垂体腺瘤经鼻蝶入路的指征和术中应注意的问题。方法 分析122例垂体腺瘤经鼻蝶显微外科治疗的情况。结果 微腺瘤32例,全切为31例(97％)。大腺瘤75例,全切51例(68％),其中鞍上20～30mm者22例,全切8例(36％)。巨大型腺瘤鞍上超过30mm者12例,仅4例全切。结论 垂体腺瘤鞍上部分超过20mm者经蝶手术不易全切,超过30mm应采用经额入路。视力极差者宜先经鼻蝶再经额两期手术。
Objective To investigate the indications of pituitary adenomas transnasal approach and the problems to be noticed in the operation. Methods 122 cases of pituitary adenoma transnasal microsurgery were analyzed. Results 32 cases of micro-adenoma, the total cut was 31 cases (97%). There were 75 cases of large adenoma and 51 cases (68%) of the complete resection. Twenty-two of them were 20-30 mm saddle and 8 cases (36%) were resected. 12 cases of giant adenoma more than 30mm saddle, only 4 cases of full cut. Conclusion Pituitary adenoma suprasellar part of more than 20mm transsphenoidal surgery is not easy to cut, more than 30mm should be used by the amount of approach. Those who have poor eyesight should go through the nasal butterflies for two more surgeries.