[1]汪洪江,赵丽萍,石文建.经鼻蝶入路手术治疗垂体腺瘤48例报告[J].中国微创外科杂志,2007,07(4):378-379.
　Wang Hongjiang,Zhao Liping,Shi Wenjian..Transsphenoidal approach operation for pituitary adenoma: Report of 48 cases[J].Chinese Journal of Minimally Invasive Surgery,2007,07(4):378-379.
点击复制

经鼻蝶入路手术治疗垂体腺瘤48例报告()
分享到：

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
07
期数:
2007年4期
页码:
378-379
栏目:
出版日期:
2007-04-20

文章信息/Info

Title:
Transsphenoidal approach operation for pituitary adenoma: Report of 48 cases
作者:
汪洪江; 赵丽萍; 石文建
河北省唐山市人民医院神经外科, 唐山063001
Author(s):
Wang Hongjiang;  Zhao Liping;  Shi Wenjian.
Department of Neurosurgery, Tangshan People’s Hospital, Tangshan 063001, China
关键词:
垂体腺瘤; 经蝶入路
Keywords:
Pituitary adenoma; Transsphenoidal approach
分类号:
R739.41
文献标志码:
A
摘要:
目的探讨经蝶入路手术治疗垂体腺瘤的疗效。 方法2000年1月～2005年12月对48例垂体腺瘤分别采用经口鼻蝶入路（17例）、经鼻蝶入路（31例）切除。经口鼻蝶入路，唇下黏膜切口，进入鼻前庭；经鼻蝶入路，右侧鼻孔进入，切开鼻中隔黏膜，最后均在两侧鼻中隔黏膜间形成通道，至蝶窦腹侧壁，打开蝶窦及鞍底，进入鞍内。结果全切37例，次全切除6例，大部切除5例。无手术死亡。15例术后一过性尿崩，7例脑脊液鼻漏。17例随访3~24个月，平均12个月，4例6个月后复发，4例怀孕生育下一代。结论对于无明显向蝶鞍外生长的垂体腺瘤，经蝶入路手术是安全可行的治疗方法。
Abstract:
ObjectiveTo study the effect of transsphenoidal approach operation for pituitary adenoma.MethodsTransoral and transsphenoidal approach operations were performed in 17 patients with pituitary adenoma, and transnosal and transsphenoidal approach operations were performed in 31 patients with pituitary adenoma, from January 2000 to December 2005. For transoral and transsphenoidal approach operations, the upper lip mucous membrane was opened to introduce into the nasal cavity. For transnosal and transsphenoidal approach operations, the instruments were inserted by way of the right nostril, and the nasal septum was opened. During both of the approaches, a tunnel was established between both sides of the nasal septum, through which the sphenoidal sinus was opened, for entering the sella through the bottom.ResultsTotal resection was completed in 37 patients, subtotal resection was completed in 6, and partial resection, in 5. No surgicalrelated death occurred. Postoperatively, transient hyperuresis was found in 15 patients, and cerebrospinal fluid rhinorrhea was seen in 7 patients. Seventeen patients were followed for 3~24 months (mean, 12 months). Recurrence was encountered in 4 patients at 6 months after operation. Four patients were pregnant and delivered of a child.ConclusionsFor pituitay adenoma not obviously extending to the parasellar, transsphenoidal approach is a safe and effective option.

参考文献/References:

[1]Sutter B, Steiner M, Lopes MBC, et al. Failure in management of pituitary tumors: discussion of 3 cases. Acta Neurochirurgica，1995,134(3-4):159-166.
[2]王集生，谢坚，罗世祺.垂体腺瘤质地与手术入路的探讨.中华神经外科杂志，2001，17（2）：106-108.
[3]Comtois R, Beauregard H ,Somma M, et al .The clinical and endocrine outcome to transsphenoidal microsurgery of nonfunctioning pictuitary adenomas. Cancer ,1991,68:860.
[4]王任直，任祖渊，苏长保，等. 扩大经蝶窦入路切除巨大或侵袭性生长的垂体腺瘤.中华神经外科杂志，2004，20（6）：437-440.
[5]Masahiko K,Mamoru T.Extended transsphenoidal approach with submucousal posterior ethmodectomy for parasellar tumors.J Neurosurg,2001,64:999-1004.
[6]王富元，陈覃，孙维晔，等.额下-经蝶入路显微手术切除巨大侵袭性垂体瘤4例.中国微创外科杂志，2005，5（11）：947-948.
[7]徐德生，任祖渊，苏长保，等.经蝶垂体瘤切除后尿崩症的临床研究.中华神经外科杂志，1995，11（4）：22.

更新日期/Last Update: 2013-11-29