| 孔令胜,陈德勤,靳峰,郭强,张浩,胡亚伟.单鼻孔直达蝶窦入路显微手术切除垂体腺瘤155例临床分析[J].济宁医学院学报,2011,(6):398-402 |
| 单鼻孔直达蝶窦入路显微手术切除垂体腺瘤155例临床分析 |
| Clinical analysis on the microsurgical resection of pituitary adenomas via single-nostril transspheniodal approach in 155 cases |
| 投稿时间：2011-10-11 |
| DOI：10.3969/j.issn.1000-9760.2011.06.006 |
| 中文关键词: 垂体腺瘤|经单鼻孔入路|经蝶窦入路|显微手术 |
| 英文关键词: Pituitary adenoma|Unilateral endonasal approach|Transsphenoidal approach|Microsurgery |
| 基金项目:国家自然科学基金资助项目(编号:81071779);山东省自然科学基金资助项目(编号:ZR2010HM040) |
| 作者 | 单位 | | 孔令胜 | 济宁医学院附属医院, 山东济宁 272029 | | 陈德勤 | 济宁医学院附属医院, 山东济宁 272029 | | 靳峰 | 济宁医学院附属医院, 山东济宁 272029 | | 郭强 | 济宁医学院附属医院, 山东济宁 272029 | | 张浩 | 济宁医学院附属医院, 山东济宁 272029 | | 胡亚伟 | 济宁医学院附属医院, 山东济宁 272029 |
|
| 摘要点击次数: 4958 |
| 全文下载次数: 801 |
| 中文摘要: |
| 目的 探讨垂体腺瘤的临床特点及单鼻孔直达蝶窦显微手术切除垂体腺瘤的方法及经验。方法 回顾性分析2006年1月~2010年12月我科采用单鼻孔直达蝶窦入路显微手术切除垂体腺瘤155例,总结垂体腺瘤的流行病学及病理特点、手术要点、并发症防治及住院时间和费用。结果 垂体腺瘤好发女性,40~49岁是好发年龄。头痛头晕、视力障碍、停经泌乳、肢端肥大是常见首发症状。泌乳素腺瘤、生长激素腺瘤及无功能腺瘤是常见内分泌学分型。病理免疫组化与临床内分泌学诊断不完全符合,生长激素腺瘤符合率最高,其次为泌乳素腺瘤。肿瘤全切127例(82%),次全切15例(10%),平均手术时间(63.40±14.87)min。术中脑脊液漏的发生率为5.8%,术后无脑脊液漏、感染及死亡等严重并发症。术后平均住院时间(6.28±1.32)d,平均住院费用(11041.36±2437.91)元。结论 垂体腺瘤有鲜明的临床特点。经单鼻孔直达蝶窦入路是治疗垂体腺瘤的一种有效可靠的手术方法,具有手术时间短、创伤小、并发症少、效果好、住院时间短、治疗费用低等优点,可作为绝大多数垂体腺瘤患者的首选治疗方法。 |
| 英文摘要: |
| Objective To explore clinical characteristics of pituitary adenoma and the experience in treating pituitary adenoma by microsurgery through single-nostril trasspheniondal approach. Methods A total of 155 patients with pituitary adenoma resected via single-nostril transspheniodal approach from Jan.2006 to Dec.2010 were analyzed retrospectively.Clinical epidemiological features, pathological characteristics, manual operative point, prevention and cure of complication as well as times and fees of hospitalization were summarized. Results Pituitary adenoma often occured in the female.The peak incidence of pituitary adenomas occured in the age group from 40 to 49 years old.Headache and dizziness, visual impairment, menstruation ceased and milk yield as well as acromegaly were common symptoms.Prolactinomas(PRL)-secreting adenomas, growth hormone(GH)-secreting adenomas and adenomas without function were common tumors.Immunohistochemical diagnosis didn't fully conform with clinical endocrine diagnosis.GH-secreting adenomas was the highest coincidence rate, and the following was PRL-secreting adenomas.Of 155 patients with pituitary adenoma, 127(82%) received total resection of the tumors and 15(10%) subtotal, the mean operative time was 63.40±14.87min.The incidence of cerebrospinal fluid leakage during transsphenoidal operation was 5.8%.There was no severe postoperative complications such as cerebrospinal fluid leakage, infection and death.The mean of the hospital stay time was 6.28±1.32 days, the cost was 11041.36±2437.91 yuan. Conclusion Pituitary adenomas had distinct clinical characteristics.The microsurgery through single-nostril transsphenoidal approach for the pituitary adenomas had advantages such as minimal invasion, short operative time, few complications, good therapeutic results, fast rehabilitation and short resident days as well as low treatment fees.The single-nostril trasspheniodal microsurgery should be first selected for the patients with pituitary adenomas. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
|
|
|
