神经内镜下经鼻蝶入路切除垂体腺瘤62例临床分析

目的总结分析神经内镜下经鼻蝶入路切除垂体腺瘤的疗效及其应用价值。方法回顾性分析我院2017年1月-2019年9月收治的垂体腺瘤患者62例,其中男性30例,女性32例;年龄27～81岁,患者平均年龄52.6岁。垂体腺瘤包括微腺瘤10例,大腺瘤38例,巨大腺瘤14例。患者接受神经内镜经鼻蝶肿瘤切除,术后行神经影像、内分泌及视力检查的随访评估。结果随访时间1～34个月,中位随访时间17个月。62例患者中,全切50例,次全切9例及大部切除3例。术后患者内分泌治愈率34.6%,视力改善率92.3%,头痛改善率83.3%。术后短暂性尿崩12例,短暂脑脊液鼻漏5例,无永久性尿崩、脑脊液鼻漏。无颅内感染、昏迷、植物生存或死亡等严重并发症。结论神经内镜下经鼻蝶入路切除垂体腺瘤是一种安全、有效的治疗方法。

Resection of pituitary adenoma through neuroendoscopic endonasal transsphenoidal approach: A clinical analysis of 62 cases

Objective To analyze the efficacy of resection of pituitary adenoma through the neuroendoscopic endonasal transsphenoidal approach and its significance in application.Methods A retrospective analysis was conducted in 62 patients (30 males and 32 females, aged 27~81 years, mean age:52.6 years) with pituitary adenoma admitted to the First Affiliated Hospital of Anhui Medical University from January 2017 to October 2019. Pituitary adenomas in these patients included microadenoma (10 cases), macroadenoma (38 cases), and giant adenoma (14 cases). The patients underwent resection of pituitary adenoma through the neuroendoscopic endonasal transsphenoidal approach, and were assessed at postoperative follow-up by neuroimaging, endocrine, and visual examinations.Results The follow-ups ranged from 1 to 34 months, with a median follow-up time of 17 months. Of the 62 patients, 50 underwent a total resection, 9 underwent a subtotal resection, and 3 underwent an extended resection. After the surgery, the patients had an endocrine disorder cure rate of 34.6%, a visual acuity improvement rate of 92.3%, and a headache improvement rate of 83.3%. Postoperative transient diabetes insipidus (12 cases) and cerebrospinal fluid rhinorrhea (5 cases) occurred in the patients, while there was no persistent diabetes insipidus or cerebrospinal fluid rhinorrhea. There were no serious complications such as intracranial infection, coma, and persistent vegetative state or death.Conclusions It is safe and effective to resect pituitary adenoma through the neuroendoscopic endonasal transsphenoidal approach.