目的 探讨大和巨大型垂体腺瘤较理想的手术治疗原则。方法 所有病例采用经唇下蝶窦入路显微镜下肿瘤切除术。结果 30例肿瘤手术全切除26例,4例肿瘤因侵袭入鞍膈上和/或海绵窦内而行大部分切除,其中1例经额术后再二期经鼻蝶入路显微切除鞍内和蝶窦内肿瘤。结论 多数大和巨大垂体腺瘤可选择经鼻蝶入路全切。 Objective To investigate the ideal surgical treatment of giant pituitary adenomas. Methods All cases underwent microsurgical resection of the lip with transsphenoidal approach. Results Totally 26 cases were resected in 30 cases and 4 cases were removed due to their invasion into the supra-diaphragm and / or the cavernous sinus. One case was treated by microsurgical removal of nasal septum Internal and sphenoid sinus tumors. Conclusions Most large and giant pituitary adenomas can be cut completely through the nasalis patellar approach.