复发性垂体腺瘤手术适应症的分析

发布时间：2018-03-20 10:47

本文选题：垂体腺瘤　切入点：复发　出处：《宁夏医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过搜集复发性垂体腺瘤患者采用不同手术方式再次治疗的临床资料,分析讨论复发性垂体腺瘤再次手术的适应症。方法:对宁夏医科大学总医院2012年01月至2015年12月共收治的35例复发性垂体腺瘤的术后并发症、临床治愈率、肿瘤全切率、肿瘤侵袭性、肿瘤大小进行分析,行X2检验,以检测结果有无统计学意义。结果:21例行经鼻蝶入路显微镜下肿瘤切除术的患者中:术后并发症发生率为23.81%(n=5/21),肿瘤全切率为76.19%(n=16/21),临床治愈率为95.23%(n=20/21),大腺瘤为100.00%(n=21/21),侵袭性肿瘤为66.66%(n=14/21);6例行经鼻蝶入路内窥镜下肿瘤切除术的患者中:术后并发症发生率为33.33%(n=2/6),肿瘤全切率为66.66%(n=4/6),临床治愈率为83.33%(n=5/6),大腺瘤为100.00%(n=6/6),侵袭性肿瘤为100.00%(n=6/6);8例行开颅垂体腺瘤切除术的患者中:术后并发症发生率为25.00%(n=2/8),肿瘤全切率为62.50%(n=5/8),临床治愈率为75.00%(n=6/8),大腺瘤为100.00%(n=8/8),侵袭性肿瘤为75.00%(n=6/8)。结论:本研究得出的手术适应症为:再次经鼻蝶窦垂体腺瘤切除术(包括内窥镜、显微镜)适应症:(1)肿瘤大部分位于垂体窝内和术中可能沉降的鞍上区;(2)瘤顶未接触大脑内静脉或堵塞室间孔,且肿瘤底部达到鞍底或进入蝶窦腔;(3)按计划分次TSS切除的巨大腺瘤。开颅手术适应症:(1)垂体窝内存在较多瘢痕组织;(2)肿瘤大部分位于鞍上,并且估计术中肿瘤主体难以满意沉降;(3)症状明显需要手术,而经蝶手术难以取得满意效果者。
[Abstract]:Objective: to collect the clinical data of patients with recurrent pituitary adenoma treated by different surgical methods. Methods: from January 2012 to December 2015, 35 cases of recurrent pituitary adenoma were treated in Ningxia Medical University General Hospital from January 2012 to December 2015. The postoperative complications, clinical cure rate and total tumor resection rate were analyzed and discussed. Tumor invasiveness, tumor size, X2 test, Results among 21 patients who underwent transsphenoidal transsphenoidal surgery, the incidence of postoperative complications was 23.81%, the total resection rate was 76.19%, the clinical cure rate was 95.23% 20 / 21, the macroadenoma was 100.000.21%, the invasive swelling was 21%. The incidence of postoperative complications was 33.33% 2 / 6, the total resection rate was 66.66%, the clinical cure rate was 83.33% 5 / 6%, the major adenoma was 100.005% / 66%, the invasive tumor was 100.00nnntir / 66%, and the invasive tumor was 100.00nn / 66 / 6%. The incidence of postoperative complications was 25.00%, the total resection rate was 62.50%, the clinical cure rate was 75.00%, the major adenoma was 100.00%, the invasive tumor was 75.00% -68%. Conclusion: the operative indication of this study is to resect the pituitary adenoma through sphenoid sinus again. Surgery (including endoscopy, Most of the tumors are located in the pituitary fossa and in the suprasaddle region where the tumor may sink during the operation. The top of the tumor does not contact the internal cerebral vein or clog the interventricular foramen. At the bottom of the tumor to the bottom of the Sellar or into the sphenoid sinus, the giant adenoma was resected by TSS according to the plan. The indication of craniotomy is: 1) there are more scar tissues in the pituitary fossa (2) most of the tumors are located on the Sella Sella, and most of the tumors are located on the Sella. And it is estimated that the main body of the tumor is difficult to be satisfied during the operation, but the transsphenoidal operation is difficult to obtain satisfactory results.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R736.4

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