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目的 :了解鼻内镜技术用于经蝶窦入路切除垂体大腺瘤的可行性。方法 :对 13例垂体大腺瘤患者采用鼻内镜下经鼻腔 蝶窦入路切除术式。结果 :肿瘤全切除 9例 (6 9.2 % ) ,大部切除 3例 (2 3.1% ) ,手术失败 1例 (7.7% )。术后 1周内视力、视野明显改善 10例 (76 .9% ) ,其中 7例接近或完全恢复正常。除 2例短暂脑脊液漏外 ,无其他严重并发症及死亡病例发生。结论 :鼻内镜用于经鼻腔 蝶窦入路切除垂体大腺瘤可获得满意的临床效果 ,但应注意避免术中出血、解剖变异、鞍旁组织向鞍内膨出、复发性垂体大腺瘤及术后不适当的瘤腔处理对鼻内镜手术操作及疗效的影响。
Objective: To understand the feasibility of endoscopic sinus surgery for resection of pituitary adenoma via transsphenoidal approach. Methods: Thirteen patients with pituitary adenoma underwent nasal endoscopic transnasal sphenoid sinus surgery. Results: Total resection in 9 cases (62.9%), partial resection in 3 cases (23.1%) and failure in 1 case (7.7%). Visual acuity and visual field in the first week after operation were significantly improved in 10 cases (76.9%), of which 7 were close to or completely returned to normal. In addition to 2 cases of transient cerebrospinal fluid leakage, no other serious complications and deaths occurred. Conclusion: Endoscopic sinus surgery for the removal of pituitary adenomas by nasal sphenoid sinus approach can achieve satisfactory clinical results, but should pay attention to avoid intraoperative bleeding, anatomical variation, parasellar tissue to the saddle bulging, recurrent pituitary gland Effect of tumor and improper tumor cavity treatment on operation and efficacy of endoscopic sinus surgery.