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目的总结经鼻蝶入路垂体腺瘤显微切除术的治疗经验。方法回顾性分析2008年7月至2010年6月收治的63例行经鼻蝶垂体腺瘤显微切除术患者的临床资料,对手术适应症、术前病人管理、手术经验技巧以及术后并发症的预防和处理进行总结及分析。结果本组63例患者均行经鼻蝶垂体腺瘤显微切除术,无死亡病人;肿瘤全切54例,大部分切除8例。1例侵袭性垂体瘤患者术后两年复发。手术全切率85.7%(54/63),92.7%(38/41)视力下降病人视力得到改善,内分泌症状改善者达88.0%(44/50)。结论经鼻蝶显微切除垂体腺瘤具有适应证广、创伤小、手术全切率高、垂体功能保留好、并发症少等优点,是安全、有效、微创的治疗方法。
Objective To summarize the therapeutic experience of microsurgical removal of pituitary adenoma by transnasal approach. Methods The clinical data of 63 patients who underwent microsurgical resection of nasal pituitary adenoma from July 2008 to June 2010 were analyzed retrospectively. The surgical indications, preoperative patient management, operative experience and postoperative complications Disease prevention and treatment to summarize and analyze. Results All the 63 patients underwent microsurgical resection of nasal pituitary adenoma with no death. Totally 54 cases were resected completely, and most of them were resected in 8 cases. One patient with invasive pituitary tumor recurred after two years. The total operative rate was 85.7% (54/63). The visual acuity of 92.7% (38/41) patients with vision loss was improved, and the improvement of endocrine symptoms was 88.0% (44/50). Conclusion Microsurgical excision of pituitary adenoma with nasal microspheres is a safe, effective and minimally invasive treatment with the advantages of wide indications, small trauma, high total excision rate, good retained pituitary function and few complications.