目的　总结高龄 (大于 70岁 )患者垂体腺瘤的临床特点、显微手术治疗和围手术期处理的体会。　方法　回顾经蝶窦显微手术治疗的 2 4例 ,对其临床特点、肿瘤病理类型、手术适应证、围手术期处理和手术疗效进行了分析和总结。　结果　无功能腺瘤占 66 7% (16/2 4) ,巨大腺瘤占 75%(18/2 4) ,临床上最常见的主诉为进行性视力、视野障碍。术后无死亡 ,其中 2 2例获得长期随访 ,随访时间平均 3 5年 ,79 2 %患者 (19/2 4)术后视力有不同程度改善。　结论　高龄垂体腺瘤以无功能巨大腺瘤多见 ,临床上主要表现为进行性视力、视野障碍和垂体功能低下 ,经蝶窦显微手术是一种安全有效的治疗手段 ,但要加强围手术期的处理 ,特别要注意保持水、电解质平衡 Objective To summarize the clinical features, microsurgical treatment and perioperative management of pituitary adenomas in the elderly (over 70 years old). Methods Twenty - four cases of microsurgical treatment of transsphenoidal surgery were retrospectively analyzed and summarized in terms of clinical features, tumor pathological types, surgical indications, perioperative management and surgical outcomes. Results Non-functioning adenomas accounted for 66.7% (16/2), giant adenomas accounted for 75% (18/2 4). The most common clinical complaints were progressive visual acuity and visual field disorders. There were no deaths after operation. Long-term follow-up was obtained in 22 of them, with an average follow-up of 35 years. Visual acuity improved in 79 2% of the patients (19/2) after operation. CONCLUSIONS: Pituitary adenomas are more common in patients with non-functioning giant adenoma. Clinical manifestations include progressive visual acuity, visual field disorders and hypopituitarism. Transanal microsurgery is a safe and effective method of treatment. However, it is necessary to strengthen perioperative Treatment, with particular attention to maintain water, electrolyte balance