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目的探讨经额下和蝶窦手术入路显微外科切除巨大垂体腺瘤的方法和经验。方法显微镜下分别采用经额下和蝶窦入路,对48例巨大垂体腺瘤实施手术治疗。结果48例巨大垂体腺瘤中显微镜下全切除26例,近全切除19例,大部切除3例,无一例死亡。肿瘤未能全切除22例术后行放射治疗。47例平均随访4.5年,34例能正常工作,11例生活自理,复发2例。结论显微外科手术治疗可提高巨大垂体腺瘤全切除率,降低病死率及复发率。
Objective To investigate the method and experience of microsurgical resection of giant pituitary adenoma by frontal and sphenoid sinus surgery. Methods Forty-eight cases of giant pituitary adenoma underwent surgery under the microscope under the frontal and the sphenoid sinus respectively. Results In 48 cases of giant pituitary adenomas, 26 cases underwent total resection under microscope, 19 cases underwent total resection, 3 cases underwent partial resection and none died. Tumor resection of 22 patients failed to complete radiotherapy. 47 cases were followed up for an average of 4.5 years, 34 cases can work normally, 11 cases take care of themselves, and 2 cases relapse. Conclusion Microsurgical treatment can improve the total resection rate of huge pituitary adenomas and reduce the mortality and recurrence rate.