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目的总结经单鼻孔蝶窦入路显微手术切除垂体腺瘤的方法及经验。方法2002年1月～2006年10月我院采用经单鼻孔蝶窦入路行垂体腺瘤切除术32例,其中微腺瘤2例,小腺瘤9例,中腺瘤16例,大腺瘤5例。结果全切除30例,次全切除2例。病理检查类型为泌乳素腺瘤27例,生长激素腺瘤3例,混合性腺瘤2例。无手术死亡病例。术后出现一过性尿崩6例,脑脊液鼻漏2例,经治疗后好转。平均随访4个月,临床症状术后短期内均有改善,激素水平术前升高的均有下降。结论经单鼻孔蝶窦入路是治疗垂体腺瘤的一种有效可靠的手术方法,具有创伤小、手术时间短、并发症少、术后康复时间短、手术死亡率低、垂体功能保存率高等优点,可作为绝大多数垂体腺瘤患者的首选治疗方法。
Objective To summarize the methods and experience of microsurgical removal of pituitary adenomas through the single nostril sphenoid sinus approach. Methods From January 2002 to October 2006, 32 cases of pituitary adenoma were treated by single nostril sphenoid sinus approach in our hospital from January 2002 to October 2006. There were 2 cases of micro-adenoma, 9 cases of small adenoma, 16 cases of adenoma, 5 cases of tumor. Results Total resection in 30 cases, subtotal resection in 2 cases. Pathological examination type of prolactinoma in 27 cases, 3 cases of growth hormone adenoma, mixed adenoma in 2 cases. No surgical deaths. Postoperative transient diabetes insipidus in 6 cases, 2 cases of cerebrospinal fluid rhinorrhea, improved after treatment. After an average follow-up of 4 months, clinical symptoms were improved shortly after surgery, hormone levels were decreased preoperatively. Conclusion Single nostril sphenoid sinus approach is an effective and reliable surgical method for the treatment of pituitary adenoma. It has the advantages of less trauma, shorter operative time, fewer complications, shorter postoperative recovery time, lower operative mortality, higher pituitary function preservation rate Advantages, can be used as the treatment of choice for the vast majority of pituitary adenoma patients.