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目的 探讨内镜经鼻蝶窦入路手术治疗急性卒中垂体腺瘤的手术技术和围手术期治疗方法.方法 回顾性分析2004年3月至2011年3月间治疗的急性卒中垂体腺瘤患者15例,男4例,女11例；平均年龄39.0岁,术前均行头CT、MRI及内分泌学检查,手术采用内镜经鼻蝶窦入路肿瘤切除术,围手术期给予补充肾上腺皮质激素.结果 本组患者中肿瘤全切12例,近全切除3例,无严重并发症及手术死亡.术后随访6 - 36个月,患者症状均明显好转,对垂体功能低下的患者给予激素替代治疗.结论 内镜经鼻蝶窦入路手术是治疗急性卒中垂体腺瘤安全、有效的方法,完善的围手术期处理措施是保证手术成功的关键.

Objective To discuss the operative techniques of endoscopic endonasal transsphenoidal surgery and perioperative management for treatment of acute pituitary apoplexy.Method From Mar.2004 to Mar.2011,15 patients were diagnosed as acute pituitary apoplexy.There were 4 male and 11 female( average age 39.0 years ).MRI scan,CT scan and endocrinological examinations were performed in all cases before operation.All patients were treated by endoscopic endonasal transsphenoidal operation.Glucocorticoids were used during perioperatve period.Results The tumors were totally removed in 12 cases and sub -totally removed in 3 cases,without operative death and serious complications.All patients were followed up from 6 to 36 months.Symptoms were improved in all cases and hormone replacement therapy was needed due to hypopituitarism.Conclusion The endoscopic endonasal transsphenoidal operation is safe and effective in treatment of acute pituitary apoplaxy.Appropriate perioperative management is important to the success of operation.