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目的 将鞍区及垂体血供的显微解剖知识应用于鞍区肿瘤的显微手术中,达到既减少术中血管损伤、又全切除肿瘤。方法 在手术显微镜下经翼点入路鞍区四个解剖间隙切除鞍区肿瘤88例,术中注意保护肿瘤周围的视神经、ICA及发出的垂体上动脉。结果 88例鞍区肿瘤,全切除84例(94.4％),死亡3例(3.4％),复发4例(4.5％)。结论 在经翼点入路行鞍区肿瘤的显微手术中,熟练掌握鞍区四个解剖间隙及垂体血供的显微解剖,是提高全切率、降低死亡及复发率的关键。
Objective To apply the anatomical knowledge of sellar and pituitary blood supply to the microsurgery of sellar tumors so as to reduce both intraoperative vascular injury and complete resection of the tumor. Methods Seventy-eight cases of sellar tumors were excised from the four anatomical spaces through the pterional approach via the pterional point under the operative microscope. The optic nerve, ICA and the pituitary artery around the tumor were protected during surgery. Results 88 cases of sellar tumors, total resection in 84 cases (94.4%), death in 3 cases (3.4%), recurrence in 4 cases (4.5%). Conclusions In microsurgery of transsexual tumor in the sellar region, mastering the anatomical space of the sellar region and the microsurgical anatomy of the pituitary blood supply is the key to improve the full-rate and reduce the rate of death and recurrence.