鞍区HRCT扫描在单鼻孔蝶窦入路切除垂体腺瘤中的作用.pdfVIP

维普资讯 · 886 · 现代生物医学进展 www．biomed．net．cn ProgressinModernBiome~cme 2008 Vo1．8 No．5 鞍区HRCT扫描在单鼻孔蝶窦入路切除垂体腺瘤中的作用 李 强 刘志雄 陈 委 刘劲芳 刘运生 (中南大学湘雅医院神经外科 湖南长沙 410008) 摘要 目的：探讨术前鞍区HRCT扫描在单鼻孔蝶窦入路切除垂体腺瘤中的作用：方法：回顾性分析42例经单鼻孔蝶窦入路垂体 腺瘤切除病人鞍区薄层HRCT检查的结果和经验 结果：蝶窦呈鞍形35例，鞍前形7例，鞍底骨质破坏 19例。术后鞍底骨窗均小 于 1．5cm× 1．5cm。肿瘤全切除28例，次全切除 10例，部分切除4例．．术后视力及视野改善者 3l例，内分泌指标恢复正常者35 例。术后脑脊液鼻漏5例。本组无死亡病例，没有出现因骨窗咬除而出现的视神经损伤、海绵窦出血等并发症。结论：鞍区薄层 HRCT检查有利于指导手术入路的设计和术中手术方位的判断 关键词 ：垂体腺瘤；手术；高分辨率CT 中图分类号：R651．1 文献标识码 ：A 文章编号：l673—6273(2008)05—0886—02 TheValueOfHRCTDiagnosisinResectionofthePituitaryAdenomas byMononostril—TranssphenOidalApproach LIOiang,LIUZhi-xiong,CHENWei,LIUfin—Fang,LIUYun—sheng (DepartmentofNeurosurgety,XiangyaHospitalCentralSouthUniversity,Changsha410008,China) ABSTRACTObjective：ToexplorethevalueofsellarthinHRCTdiagnosisinresectionofthepituitaryadenomasbymononos— tril-transsphenoidalapproach．Methods：Theclinicalfeautresandoutcomesof42patients’sellarthinHRCTwithpiutitary adenomawere analyzedretrospectively、Results：Thereare35patientswithsaddleshapeofsphenoidalsinusand7withanteriosaddleshape．Thesellar floorsweredevastatedin 19patients．Theareaofbonewindow islessthan 1．5cm × l、5cm、Tumorsweretotallyremovedin28cases． andsubtoatllyresectedin l0patients．Nopatientdiedaftertheoperation、Endocrinesymptom of35patientsreutrnedtothenormallevel， thesmy ptom oftheother5caseswereimproved．3lpatientswithvisualfielddefectsrecoveredaftertheoperation．Cerebrospinalfluid leakageoccurredin5patients．andtheywerecuredwithconservativetreatmentin2weeks．Conclusion：ThesellarthinHRCTdiagnosis hasadvantageintheresectionofthepiutitary adenomasbymononostril—transsphenOidalapproach． KeyworM ：Piutitary adenoma，Transsphenoidalapproach，Operation，HRCT ChineseLibraryClassificati