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[目的]探讨经单鼻孔蝶窦入路神经内镜下垂体腺瘤切除手术技术。[方法]对符合病例入选标准的垂体瘤患者给予单鼻孔蝶窦入路神经内镜下垂体腺瘤切除手术,观察手术情况。[结果]本组58例患者均成功完成手术,术后随访1～12个月,平均(6.2±0.3)个月;其中肿瘤全切除45例,次全切除13例;手术时间1～2.5h,平均(85±13.8)min,本组58例患者术后有13例患者出现尿崩症,其中12例短期内恢复,1例经使用垂体后叶素或醋酸去氨加压素(20mg/d)1～2周后恢复;5例患者出现轻度的脑脊液鼻漏,经对症处理后好转;未发生脑脊液鼻漏及视力恶化。[结论]经单鼻孔蝶窦垂体瘤神经内镜手术技术简便、安全和有效,提高肿瘤全切率。
[Objective] To explore the surgical technique of endoscopic pituitary adenoma excision through the single nostril sphenoid sinus approach. [Method] The patients with pituitary adenoma who met the selected criteria were given the single nostril sphenoid sinus approach for endoscopic pituitary adenoma resection and the operation was observed. [Result] All the 58 patients in this study were successfully performed. The patients were followed up for 1 to 12 months with an average of (6.2 ± 0.3) months. Among them, 45 cases were completely resected and 13 cases were subtotally resected. The operation time was 1-2 h , Average (85 ± 13.8) min. Fifty-eight patients in this group had post-operative diabetes insipidus. Twelve of them were recovered in a short period of time, one was treated with pituitrin or desmopressin acetate (20 mg / d) recovered in 1 ~ 2 weeks; mild rhinorrhea in cerebrospinal fluid in 5 patients showed improvement after symptomatic treatment; no cerebrospinal fluid rhinorrhea and visual deterioration occurred. [Conclusion] The neurosurgery technique of the single nostril pituitary tumor is simple, safe and effective and improves the rate of tumor resection.