神经内镜辅助下经蝶单鼻孔入路切除垂体腺瘤 - 昆明医科大学学报.PDF

昆明 医 学院学报 2009 ，（1 ）：61 ~ 63 CN 53 - 1049 R Journal of Kunming Medical University 神经内镜辅助下经蝶单鼻孔入路切除垂体腺瘤 黎，唐太昆，毛希宏，李建辉 昆明市延安医院神经外科，云南昆明 650051） ］ 、疗效及体会 ［摘要 目的 介绍经单鼻孔入路神经内镜下切除垂体腺瘤的手术方法 ．方法 11 例垂体腺 瘤患者采用此手术方法予切除．结果 内镜下肿瘤全切8 例，部分切除3 例，无严重并发症及死亡．术后随访 6 ～12 月，4 例视力、视野障碍显著改善，3 例月经恢复，泌乳停止，2 例肢端肥大骨痛症状明显好转，1 例视 力下降改善不显著．结论 单鼻孔入路神经内镜下垂体腺瘤切除术创伤小、手术时间短、手术视野广、照明 好、并发症少、病人恢复快等优点． ［关键词］神经内镜手术；垂体腺瘤；经鼻蝶外科 ］ ］ ］ ［中图分类号 R736.4 ［文献标识码 A ［文章编号 1003 －4706 （2009）01 －0061 －03 Neuroendoscopic Microsurgery of Pituitary Adenomas through Unilateral Endonasal Transsphenoidal Approach SONG Li ，TANG Tai －kun ，MAO Xi －hong ，LI Jian －hui （Dept. of Neurosurge ry ，Y anan Hospital ，Kunming Y unnan 650051 ，Chian） Abstract］Objective To explore the operative skills and experience of the neuroendoscope-assisted uni- lateral endonasal transsphenoidal microsurgery of pituitary adenoma．Methods The clinical data of 11 patients with pituitary adenomas who had accepted endonasal transsphenoidal microsurgery from Jan uary 2004 to June 2006 were analyzed retrospectively．Results Total removal of tumors was made in 8 cases ，subtotal removal in 3 cases．No death happened postoperatively．The median time of followup was 6 ～12 months．During the fol- lowup ，the visual disorder was improved in 4 cases．Megalakria was relieved obviously in 2 cases and galactorrhea was cured in 3 cases．Conclusions Neuroendoscope-assisted endonasal transsphenoidal surgery for pituitary adenomas makes maximal use of natural space of nasal cavity ，which has many advantages ，such as direct ap- proach ，minimal invasion ，short operative time ，and less post