垂体腺瘤假包膜囊外切除术的临床研究-神经疾病与精神卫生.pdfVIP

神经疾病与精神卫生2017年第17卷第3期 ·学术交流· 垂体腺瘤假包膜囊外切除术的临床研究 张铭芙 刘宁 李莹 孟祥喜 战华 苗健烨 王宁 【摘要】　目的　探讨垂体腺瘤行假包膜囊外切除术的临床意义。方法　选取2015 年4 月~2016 年 7 月行经蝶窦入路切除垂体腺瘤的173例患者，根据假包膜囊外及囊内切除进行分组，对比其全切率、生 物学治愈率及并发症情况。结果　173例患者中，90 例发现假包膜(52.0%) ，其中无功能型和生长激素型 垂体腺瘤假包膜发现率较高。囊外切除组肿瘤全切率(95.6%) 高于囊内切除组(88.0%) ，但差异无统计 2 学意义；功能型腺瘤中囊外切除组生物学治愈率亦较高(89.7% 比71.4%) ，差异有统计学意义( χ=4.279， P ＜0.05) ；术中脑脊液漏发生率分别为47.8% 和41.0% ，术后脑脊液漏发生率为0 ；术后病理学证实假包 膜有肿瘤细胞浸润。结论　垂体腺瘤假包膜囊外切除能够提高肿瘤全切率及功能型垂体腺瘤的生物学 治愈率，且不增加术后并发症，是一种安全、有效的切除方式。 【关键词】　垂体腺瘤； 假包膜； 囊外切除 - doi ：10.3969/j.issn.1009 6574.2017.03.011 - Pseudocapsule based extracapsular resection of pituitary adenoma　ZHANG Ming fu ， LIU Ning ， LI Ying ， et al. Department of Neurosurgery ， the First Affiliated Hospital ， Harbin Medical University ， Harbin 150001， China 【Abstract 】　Objective　To investigate the clinical significance of pseudocapsule based extracap- sular resection of pituitary adenomas. Methods　Totals of 173 patients who underwent tumor resection from April 2015 to July 2016 were selected. All patients were divided into two groups according to pseudocapsule based extracapsular or intracapsular resection. Total removal rate ， biology cure rate and complications were evaluated. Results　In the 173 patients ， pseudocapsule was found in 90 patients (52.0%) and mostly was found in non-functional and growth hormone secreting pituitary adenoma. No significant differences were found in to- tal removal rate between extracapsular resection group (95.6%) and intracapsular resection group (88.0%). In patients with functional pituitary adenoma ， biology cure rate of patients in extracapsular resection group was