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目的:评估鼻内镜下经鼻蝶入路手术治疗垂体卒中的可行性及疗效。方法:经手术及病理证实为垂体卒中的患者42例,术前均行头CT、MRI及内分泌学检查,手术均采用鼻内镜下经鼻蝶入路,围手术期补充肾上腺皮质激素,记录术后症状恢复情况及术后随访结果。结果:肿瘤全切36例,次全切除6例。术后随访0.5~13年,42例患者头痛消失或明显减轻,34例(91.9%)视觉功能障碍消失或缓解,17例(77.3%)垂体功能提高,无严重并发症及死亡病例发生,未发现复发病例。结论:内镜下经鼻蝶入路手术治疗垂体卒中是安全、有效、微创的手术方法。
Objective: To evaluate the feasibility and efficacy of endoscopic transnasal approach for pituitary apoplexy. Methods: Forty-two patients with pituitary apoplexy confirmed by operation and pathology were performed CT, MRI and endocrinology examinations before operation. All patients underwent nasal endoscopic transnasal approach and perioperative adrenal cortex hormones. After the recovery of symptoms and postoperative follow-up results. Results: The tumor was completely resected in 36 cases and subtotal resection in 6 cases. During the follow-up of 0.5 to 13 years, the headache disappeared or was significantly alleviated in 42 patients. Visual dysfunction disappeared or alleviated in 34 patients (91.9%). Pituitary function was improved in 17 patients (77.3%) without serious complications and deaths. Found recurrent cases. Conclusion: Endoscopic transnasal approach for pituitary apoplexy is safe, effective and minimally invasive surgery.