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目的探讨经单鼻蝶入路切除垂体腺瘤的方法、技巧和疗效。方法回顾性分析28例垂体腺瘤,其中大腺瘤21例,微腺瘤7例;无功能腺瘤17例,垂体泌乳素(PRL)腺瘤6例,生长激素(GH)腺瘤3例,泌乳素+生长素腺瘤2例。所有患者术前均行显微镜下单鼻蝶入路手术治疗,分析切除效果、术后并发症及随访情况。结果本组肿瘤全切除23例(82.2%),近全切除3例(10.7%),部分切除2例(7.1%)。术后尿崩3例,鼻出血1例,脑脊液鼻漏2例,无死亡病例。术后随访时间为1~10个月,临床症状和内分泌学指标均有所改善。结论显微镜下经单鼻蝶垂体腺瘤切除术是治疗垂体腺瘤安全有效的手术方法,具有创伤小、术野清晰、操作简单安全及术后并发症少等优点。
Objective To investigate the method, technique and curative effect of pituitary adenoma excised by single nasal butterfly approach. Methods A retrospective analysis of 28 cases of pituitary adenomas, including 21 cases of large adenoma and 7 cases of microadenoma; 17 cases of non-functioning adenoma, 6 cases of pituitary prolactin (PRL) adenoma, 3 cases of growth hormone (GH) adenoma , Prolactin + auxin adenoma in 2 cases. All patients underwent microsurgical microsurgery under a single nasal approach before surgery, analysis of resectability, postoperative complications and follow-up. Results Totally 23 cases (82.2%) underwent total resection, 3 cases (10.7%) underwent total resection and 2 cases (7.1%) partially resected. Postoperative diabetes insipidus in 3 cases, nosebleed in 1 case, cerebrospinal fluid rhinorrhea in 2 cases, no deaths. Follow-up time was 1 to 10 months, clinical symptoms and endocrine indicators have improved. Conclusions Under the microscope, the single nasal pituitary adenoma resection is a safe and effective surgical method for the treatment of pituitary adenoma. The method has the advantages of small trauma, clear operative field, simple and safe operation and less postoperative complications.