神经内窥镜下经鼻蝶入路手术治疗垂体瘤体会.docVIP

神经内窥镜下经鼻蝶入路手术治疗垂体瘤体会 　　【摘要】目的：进一步探讨神经内窥镜经鼻蝶入路在治疗脑垂体瘤中的应用。方法：对15例垂体瘤病人采取神经内窥镜引导下的经鼻蝶窦入路手术。结果：14例瘤组织得到了完全切除，1例因瘤组织侵犯鞍旁颈内动脉行大部分切除，术后所有病人症状明显改善。术后2例病人出现短暂性尿崩，l例出现出现短暂性垂体功能低下，无余并发症发生，8例术前血清泌乳素水平异常的病人术后恢复正常。5例术前血清生长激素水平异常的病人术后血清水平低于5．0，随访3～60个月，1例复发。结论：神经内窥镜经鼻蝶入路垂体瘤切除术是一种简便、安全、微创的外科技术。 　　【关键词】神经内窥镜垂体瘤蝶窦微侵袭技术 　　 　　Peep a mirror bottom to go into road surgical operation a treatment to hypophysomathrough the nasal and sphenoid cells inside nerve 　　Liu Jianyong1Zhao jun1Huo Qijun2Kang Tiejiang1 　　【Abstract】Objective:The further study is inside nerve peep a mirror through the nose Die go into the road is in the treatment the brainhypophysoma application.Method:To 15 hang body lump a patient to adopt inside nerve peep under the mirror leading of Be gone into road surgical operation by nasal and sphenoid cells Dou.Result:14 lump organization got Complete cut off, 1 because of lump organization infringe upon saddle side the artery in the neck line big part cut off, operation empress all patients symptom obvious improvement.operation Empress 2 patient appear brief sex urine to collapse, the l example appear brief to hang body function lowly, have no remaining complications occurrence, 8 before the Operation Serum Bi milk vegetable level abnormality of patient instauration after the operation normal.5 before the operation the hormone level of the serum growth abnormality of patient after the operation serumThe level is low in 5.0, with visit for 3~60 months, 1 relapse.Conclusion:Peeping a mirror to go into road hypophysoma resection through the nose Die inside nerve BEA kind of simple, safety, tiny surgery technique for create. 　　【Key words】peep mirror hypophysoma sphenoid cells microinvasion technic 　　 　　自1906年Schioffer首例报道经蝶窦成功切除垂体肿瘤以来，经蝶窦入路垂体瘤切除术目前已被公认为是一种较好的手术入路。为进一步评估认识内窥镜垂体瘤手术，我们自2003年至今应用神经内窥镜经鼻蝶入路治疗垂体腺瘤15例，取得了满意的效果，现将治疗情况报道如下： 　　 　　1临床资料 　　 　　1.1一般资料：15例中男9例，女6例。年龄28～62岁，平均39．9岁。病程0．6~5年。 　　1.2临床表现：视力视野障碍8例，停经5例，泌乳3例，肢端肥大4例，性欲减退9例，阳痿2例。 　　1.3影像学检查：全部患者行CT增强和