CT神经导航在经鼻蝶垂体瘤手术中的应用
Journal of Otolaryngology and Ophthalmology of Shandong University(2009)
Abstract
目的 探讨神经导航系统在经蝶垂体瘤手术中的应用.方法 62例患者术前行CT2mm薄层扫描,术中应用导航定位,指导手术操作.结果 本组62例,42例行全切除术,19例行次全切除术,1例行部分切除术.无手术死亡,无术后出血及脑膜炎发生,无鼻中隔穿孔.术后52例得到随访,随访2个月~2年,无复发.术前视力、视野障碍患者36例,术后改善33例,3例术前失明患者术后视力无恢复;术前月经紊乱和闭经患者6例,术后恢复正常4例;术前泌乳素高患者6例,术后恢复正常4例;生长激素增高患者6例,术后均恢复正常.术后发生脑脊液漏2例,一过性尿崩2例,电解质紊乱4例,经治疗均恢复正常.4例出现垂体功能低下,需长期激素替代治疗.结论 CT神经导航在经蝶垂体瘤手术中定位准确,安全性高,利于提高肿瘤全切率,减少手术并发症.
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Key words
neuro-navigation,trans-sphenoidal approach,pituitary adenomas,microsurgery,vision,resection,computed tomography,surgery
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