纯内窥镜下单鼻孔经蝶入路垂体瘤切除术术后短期并发症-外科学专业论文.docxVIP

— — PAGE 1— 摘 要 纯内窥镜下单鼻孔经蝶入路垂体瘤 切除术术后短期并发症 研究生：刘轶刚 导师：张庭荣副教授 摘 要 目的: 评估纯内窥镜下单鼻孔经蝶窦入路垂体瘤切除术术后短期并发症。初步 探讨其产生原因。方法:前瞻性收集 2007 年 9 月—2009 年 1 月我科开展纯内窥镜下 单鼻孔经蝶窦入路垂体瘤切除术以来 114 例该术式患者术后短期并发症临床资料并 根据解剖结构和系统将并发症分成几组（鼻腔并发症；蝶窦并发症； 鞍区并发症； 鞍上并发症；鞍旁并发症；内分泌功能并发症。）。并与国外同行报道资料对比。结 果: 肿瘤全切除 89 例, 次全切除 11 例, 部分切除 14 例。术后并发鼻衄出血 1 例,嗅 觉障碍 11 例，蝶窦炎 5 例，脑脊液鼻漏 12 例,动眼神经损伤 1 例，垂体前叶功能低 下 36 例，暂时性尿崩症 23 例,严重蛛网膜下腔出血 2 例，残瘤出血或肿胀 1 例，脑 膜炎 5 例，死亡 2 例。与传统显微镜经蝶入路手术相比手术并发症明显降低，可能 与手术通道损伤减少，术中内窥镜提供了良好的手术视野有关。结论: 经蝶窦手术 无论是显微镜还是内窥镜对于熟练医生来说都是一种安全操作。但是严重的并发症 依然会出现，必须尽可能通过不同方法使之减少。随着设备的完善、技术的进步， 并发症将进一步的减少。团结协作的团队包括不同专业的专业同事在垂体瘤治疗中 成为不可或少的必要因素 关键词： 并发症；内窥镜；垂体瘤；经蝶窦；手术 新疆医科大学医学硕士学位论文 Surgical complications associated with the pure endoscopic endonasal transsphenoidal approach for pituitary adenomas Postgraduate: Liu Yigang,Supervisor: Prof. Zhang Tingrong Abstract Objective: To assess postoperative complications related to the surgical procedure of the pure endoscopic endonasal transsphenoidal approach for pituitary adenomas . Methods:A retrospective analysis was conducted in a series of 114 consecutively treated patients who underwent an endoscopic endonasal transsphenoidal approach to the sellar region for resection of pituitary adenomas between September 2007 and August 2008 . Complications were divided into groups (nasofacial, sphenoid sinus, sella turcica, supra or parasellar, and endocrine complications) according to the anatomical structures and the systems involved. Results: In114 patients,89 cases , total resection of adenomas.11 cases, subtotal resection. 14 cases, partial resection. Postoperative complications include epistaxis(1of114), sphenoid sinusitis (5of114), CSF leakage (12 of 114), anterior pituitary insufficiency (36of114), posterior pituitary insufficiency (23of114), hemorrhage / swelling of residual tumor (1of 114), meningitis (4of114),death (2of114). Overall, a decreased incidence of complications has been observed, compared with large historical series of the t