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目的探讨显微外科治疗大及巨大垂体腺瘤手术方法的选择。方法对CT或MRI证实的56例大及巨大垂体腺瘤,采用经蝶入路或经颅入路两种手术方法,在显微镜下切除肿瘤。结果经蝶手术18例,全切除12例,次全切除6例,无一例死亡。经颅采用翼点或经额入路显微手术治疗38例,经额手术25例,全切除22例,次全切2例,部分切除1例,其中1例死亡,原因不明;经翼点13例,全切除10例,次全切2例,部分切除1例,无一例死亡。结论采用显微外科技术,针对肿瘤的特点选择不同的手术入路是提高垂体腺瘤全切率、降低死亡率的关键。
Objective To investigate the surgical treatment of large and huge pituitary adenoma by microsurgery. Methods Fifty-six large and giant pituitary adenomas proved by CT or MRI were divided into two groups by transsphenoidal approach or transcranial approach. The tumors were excised microscopically. Results 18 cases of transsphenoidal surgery, total resection in 12 cases, subtotal resection in 6 cases, no case of death. Twenty-eight cases underwent transcranial microsurgery or transnemic approach. Twenty-two cases underwent partial resection, partial resection in 2 cases and partial resection in 1 case, of which 1 died. The cause was unknown. Thirteen patients underwent total resection in 10 cases, subtotal resection in 2 cases, partial resection in 1 case, and none in death. Conclusion Using microsurgical techniques to select different surgical approaches according to the characteristics of the tumor is the key to improve the rate of full-thickness pituitary adenoma and reduce the mortality.