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分期手术切除巨大型垂体腺瘤 被引量:1

Removing giant pituitary adenoma by staging operation
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摘要 目的探讨经颅入路与经蝶窦入路分期切除不同生长方式的巨大型垂体腺瘤的手术方法及临床意义。方法回顾性分析行经颅与经蝶窦入路分期手术的15例巨大型垂体腺瘤患者的临床表现、影像学特点及手术方案,研究不同形态及生长方式的手术疗效。本组病例根据生长方式的不同分为:(1)单纯向上呈葫芦形生长经额下入路及经蝶窦入路手术者5例。(2)向鞍上及鞍旁生长经翼点入路及经蝶窦入路手术者7例。(3)向第三脑室及侧脑室内生长经侧脑室入路及经蝶窦入路手术者3例。二次手术间隔时间1~3个月,均采用显微外科。结果其中肿瘤全切除9例,次全切除4例,大部切除2例,无死亡病例。结论手术前根据病史和影像学资料、肿瘤的形态及生长方式、所累及的解剖腔隙和重要结构,选择合理的分期手术方法,才能取得较好的临床治疗效果。 Objective To evaluate the operative method and the clinical significance of staging operation removing giant pituitary adenoma in variety of forms through the trans-cranial approach and the trans-sphenoidal sinus approach. Methods Investigated the operative effect of different growing manner of the giant pituitary adenoma by analyzing the characteristics of the clinical histories, the imageological phenomena, and their operational procedures of 15 patients who underwent operations through trans-cranial and trans-sphenoidal sinus approach. According to stages all cases were classified as foUows:5 cases out of which growing purely towards upper saddle area looking like a cucurbit were done through trans-subfrontal and the trans-sphenoidal sinus,7 cases out of which growing towards the upper saddle area and parasaddle were solved through trans-pterion approach and trans-sphenoidal sinus, 3 cases out of which growing towards the third ventricle and lateral ventricle were solved via lateral ventricle and trans-sphenoidal sinus, and the interval between the two operations changed from 1 to 3 months. All cases were done under the operative microscope. Results Nine of them were removed completely, 4 almost completely, and 2 partially. No patients were died in operations. Conclusion The suitable chosen staging operation, which is based on clinical history and radiological data, the growth pattern of adenomas and involved anatomic lacunas, could obtain better clinical therapeutic results and avoid injury to the vital anatomy structures.
出处 《中国医师进修杂志(外科版)》 2007年第9期25-27,共3页 Chinese Journal of Postgraduates of Medicine
关键词 垂体肿瘤 分期手术 手术入路 Pituitary adenoma Staging operation Operative approach
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