论文部分内容阅读
目的研究筛窦蝶窦入路(筛蝶组)与单鼻孔入路(单鼻孔组)垂体瘤切除术的疗效和特点。方法回顾性分析186例经筛蝶入路与512例单鼻孔入路垂体瘤切除术病人的临床资料,对比两组病人手术前后内分泌、影像学和临床表现。结果筛蝶组肿瘤全切121例,次全切除50例,部分切除15例;单鼻孔组全切408例,次全切除87例,部分切除17例。视力、视野障碍者恢复正常或明显改善,筛蝶组46例,单鼻孔组142例。病人术后泌乳停止或减少,筛蝶组55例,单鼻孔组134例。筛蝶组术后出现尿崩症24例,并发脑脊液鼻漏5例,发生术侧单眼失明4例;单鼻孔组术后出现尿崩症13例。两组均无死亡。结论筛蝶入路和单鼻孔经蝶入路显微手术是治疗垂体腺瘤的有效方法,单鼻孔入路在彻底切除肿瘤和残存垂体功能保护方面优点更明显,创伤小,手术时间短,并发症少。
Objective To study the efficacy and characteristics of resection of ethmoid sinuses (sieve group) and single nostril (single nostril) pituitary tumor. Methods The clinical data of 186 patients with pituitary tumor resected by sieve-butter and 512 patients with single nostril were retrospectively analyzed. The endocrine, radiological and clinical manifestations of the two groups of patients before and after surgery were compared. Results The tumor of Sifu group was totally resected in 121 cases, subtotal resection in 50 cases and partial resection in 15 cases. The single nostril group was resected in 408 cases, subtotal resection in 87 cases and partial resection in 17 cases. Visual acuity, visual impairment were returned to normal or significantly improved, screened butterfly group 46 cases, single nostril group 142 cases. After the patient’s lactation stopped or reduced, 55 cases of sieve butterfly group, single nostril group of 134 cases. There were 24 cases of diabetes insipidus and 5 cases of cerebrospinal fluid rhinorrhea after operation in 4 cases. There were 4 cases of monocular blindness in the operation side and 13 cases of diabetes insipidus in the single nostril group. No death occurred in either group. Conclusion The microsurgical treatment of pituitary adenoma by sieve-butt-entry and single-nosy-transsphenoidal microsurgery is an effective method to treat pituitary adenoma. The single-nostril approach has more advantages in complete resection of the tumor and residual pituitary function protection with less trauma and shorter operative time Disease less.