摘要
目的:探讨经单鼻孔-蝶窦入路显微镜下切除垂体催乳素微腺瘤的疗效。方法:采用经单鼻孔蝶窦入路显微镜下切除术治疗垂体催乳素微腺瘤20例。先扩张术侧鼻腔,将扩鼻器直接插入鼻孔深处直抵蝶窦前壁,扩张后鼻中隔被完整地推向对侧。在手术显微镜下,分离蝶窦前壁的黏膜,然后凿开蝶窦前壁进入蝶窦,打开鞍底,切除肿瘤。此过程据鼻腔及蝶窦鞍区的CT三维骨床位的重建图像指示的解剖标志严格按中线进入。结果:本组无死亡病例及严重并发症,随访3个月至2年,催乳素水平手术前(107.53±66.65μg/L)与手术后(20.60±11.71μg/L)有显著性差异(Ρ<0.001),治愈率为90%,与同期行手术治疗的催乳素大腺瘤的治愈率35%相比有极显著性差异(P<0.001),并发症发生率为15%,且呈一过性,复发率为5.56%。结论:经单鼻孔蝶窦入路显微镜下行催乳素微腺瘤切除术,安全、有效、治愈率高。
Objective： To discuss the effect of pituitary microprolactinomas resected via a single-nostri approach to sphenoidal sinus under the operative microscope. Methods;All ：20 patients were operatedon on via a single-nostri approach to sphenoidal sinus . After the nasal cavity was dilated, the speculum was put straightly upon to the anterior wall of sphenoidal sinus, As expanding the speculum ,the middle septum was perfectly pressed to the opposite side. Under the operative microscope,the anterior wall mucosa of the sphemoidal sinus was dissected away,the anterior wall bone of the sphenoidal sinus was chipped off the bottom of sphenoidal saddle was opened up,and tumour was resected. These operations were done along the middle line according to the anatomy signs of the three dimension CT images of the sphenoidal sinus. Results：None of the patients suffered from permanent severe complications and the operative mortality was zero. All patients were followed up 3 months to 2 years. The level of prolactin had obvious difference between preoperatlone and postoperation（P〈0. 001）,the curative rates were 90% ,The rates of complications were 15 % and were temporary, the rates of relapse were 5.56%. Conclusion ：This operation to miocroprolactinomas is safe,efficient and the rate of cure is high.
出处
《陕西医学杂志》
CAS
北大核心
2006年第9期1099-1101,共3页
Shaanxi Medical Journal
