摘要
目的探讨显微神经外科技术经单鼻孔-鼻中隔根部-经蝶窦入路切除垂体腺瘤手术入路的临床效果. 方法显微镜下长鼻镜辅助观察、扩张中鼻道,扩张器置入直达蝶窦前壁、骨性鼻中隔根部,将鼻中隔自根部折断连同对侧鼻黏膜一起推向对侧,余步骤同传统经蝶手术. 结果全组70例中,62例近全切除(>95%),6例大部切除(76%～95%),2例仅为部分切除(≤75%).无手术死亡.术后24例一过性尿崩,均于3周内自愈;8例脑脊液鼻漏,5例卧床2周自愈,3例行腰大池引流治愈.48例随访3个月～2年,平均7个月,2例复发. 结论单鼻孔-鼻中隔根部-经蝶窦入路切除垂体腺瘤疗效满意,对手术通道即鼻部组织损伤小,不必分离鼻中隔及两侧黏膜,手术技术容易掌握,省时间,并发症少.
Objective To evaluate clinical effects of transnasal transseptal transsphenoidal approach adenomectomy. Methods Under the assistance of nasoscopic observations, a dilator was advanced to the anterior wall of the sphenoidal sinus and the bony septum to expand the middle nasal meatus. The nasal septum was then broken off at the root and pushed to the opposite side along with contralateral mucous membrane. The remaining process was the same as the traditional transsphenoidal procedure. Results Out of the 70 cases, a gross total resection (>95%) was performed in 62 cases, a subtotal resection (76%~95%) was performed in 6 cases, and a partial resection (≤75%), 2 cases. No peri-operative deaths occurred. Transient diabetes insipidus was noted in 24 cases and was cured within 3 weeks after operation. Nasal cerebrospinal fluid leakage was observed in 8 cases, 5 of which spontaneously recovered after 2 weeks of bed rest, and 3 of which were cured by lumbar cistern drainage. Follow-up observations for 3 months ~ 2 years (mean, 7 months) in 48 cases found 2 cases of recurrence. Conclusions Transnasal transseptal transsphenoidal approach adenomectomy is an effective and minimally invasive procedure, with simplicity to performance, short operative time and fewer complications.
出处
《中国微创外科杂志》
CSCD
2005年第7期567-568,共2页
Chinese Journal of Minimally Invasive Surgery
关键词
鼻中隔
经蝶
垂体腺瘤
手术
Nasal septum
Transsphenoidal
Pituitary adenoma
Operation
