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目的 :通过对 2 8例大和巨大型垂体腺瘤采用不同入路的手术治疗结果进行分析 ,探讨较理想的治疗原则。方法 :2 8例分经蝶组及经额组各 15、13例。经蝶组采用经唇下蝶窦入路显微镜下肿瘤切除术 ,术中配合PEEP使鞍上部分肿瘤塌陷达到完整切除。经额组采用经额底入路显微镜下肿瘤切除术。结果 :2 8例肿瘤中 ,手术全切者经蝶组为 11例 ,经额组为 10例 ,只行大部切除者经蝶组 3例 ,经额组 4例 ,原因均为肿瘤侵袭入鞍膈上及海绵窦内无法全切。结论 :经蝶入路手术创伤小 ,患者反应轻 ,并发症少 ,有广泛应用的前景
OBJECTIVE: To analyze the results of surgical treatment of 28 giant and large pituitary adenomas using different approaches and discuss the ideal treatment principle. Methods: There were 15,13 cases in 28 cases of meridian and meridians group. Transeptal group by subrethral sphenoid sinus surgery under the microscope, with PEEP surgery to collapse the upper part of the tumor to achieve complete resection. Twenty patients underwent transurethral resection of tumors undergoing microscopic resection. Results: Of the 28 tumors, 11 were transected in the transsphenoidal surgery group and 10 in the transthoracic transection group, 3 in the transsphenoid group and 4 in the transthoracic group, all of which were due to tumor invasion Saddle diaphragm and cavernous sinus can not be cut. Conclusion: Traumatic transsphenoidal approach has the advantages of less trauma, less reaction, fewer complications and wide application prospect