经额下-眶-翼入路显微手术治疗巨大型垂体腺瘤

【摘要】 目的 总结巨大型垂体腺瘤的显微手术治疗经验。方法 对2000年1月～2007年1月采用经额-眶-翼入路显微手术切除巨大型（直径≥40 mm）垂体腺瘤117例巨大型垂体腺瘤的手术情况进行回顾性分析研究。结果 全切肿瘤同时垂体柄保留完好者94例（80.4%），次全切16例，大部切除7例。98例获得术后随访，术后复发7例。结论 经额下-颞-翼入路，进行显微手术，能明显提高巨大型垂体腺瘤的全切率。

【关键词】 垂体腺瘤； 经额眶翼； 显微手术

Microsurgical Removal of the giant pituitary adenoma via transorbital subfrontal pterional approach；WANG Xinjun, Department of Neurosurgery,the Fifth Affiliated Hospital of Zhengzhou University ； Zhengzhou 450052 ,China

Abstract Objective To anaslysis the microsurgical operative experience of the giant pituitary adenoma. Methods A retrospective analysis had been made of 117 patients with giant pituitary adenoma in our department in last 10 years,all patients were operated via the transorbital subfronta pterional approach. Results Total removal of the tumor and anatomically preserved of the pituitary stem were achieved in 94cases(80.4%).The others were subtotally removed. Conclusion Microsurgial technique via the transorbital subfrontal pterional approach can improve the total remove rate of the giant pituitary adenoma.

Key Words Pituitary adenoma Transorbital subfronta pterional approach Microsurgical technique

我科自2000年1月～2007年1月采用经额-眶-翼入路显微手术切除巨大型（直径≥40 mm）垂体腺瘤117例, 均经病理证实，手术中全切率逐年有所提高，现报道如下。

1 资料与方法

1.1一般资料 本组117例，男49例，女68例，年龄12～68岁，平均41.6岁。其中复发性肿瘤16例。

1.2症状与体征 主要症状：视力下降、视野缺损、头痛和内分泌改变。其中视神经损害症状：单眼或双眼视力下降98例，单眼或双眼象限或颞侧偏盲者68例；视力在0.1以下32只眼，复视12例，失明19只眼。颅内压增高症状31例。术前尿崩11例。

1.3影像学检查 所有病人均经X线平片检查，均有不同程度的骨质破坏和