临床医学进展  >> Vol. 6 No. 3 (September 2016)

经鼻蝶垂体腺瘤手术治疗进展
Progress of Transsphenoidal Ectomy of Pituitary Adenomas

DOI: 10.12677/ACM.2016.63024, PDF, HTML, XML, 下载: 1,425  浏览: 2,617  科研立项经费支持

作者: 程 友, 薛 飞, 吴明海:南京军区南京总医院,耳鼻咽喉–头颈外科,江苏 南京;杭春华:南京军区南京总医院,神经外科,江苏 南京

关键词: 垂体肿瘤手术入路经鼻蝶神经内镜核磁共振神经导航Pituitary Adenoma Surgical Approach Transsphenoidal Neuroendoscopic Magnetic Resonance Imaging Neural Navigation

摘要: 目前对于垂体瘤的治疗主要以手术为主,辅以药物治疗及放射治疗。随着科技的不断发展,垂体瘤的手术方式也在不断地发展更新。主要包括经鼻蝶入路术式、显微镜经鼻蝶手术、内镜下经鼻蝶入路。同时 MRI及神经导航也运用到垂体腺瘤手术中。文中就经鼻蝶入路手术治疗垂体腺瘤作一综述,以提高对垂体腺瘤治疗的认识。
Abstract: At present, surgery is the mainly treatment of pituitary adenomas, supplemented by drug therapy and radiotherapy. The means of ectomy of pituitary adenomas is developed constantly, including transsphenoidal surgical approach, transsphenoidal microsurgery approach and eurotranssphe-noidal neuroendoscopic surgery. Magnetic resonance imaging (MRI) and neural navigation are also used in the ectomy. In the paper, we summarize the transsphenoidal surgical approach, in order to improve the understanding of the treatment of pituitary adenoma.

文章引用: 程友, 薛飞, 吴明海, 杭春华. 经鼻蝶垂体腺瘤手术治疗进展[J]. 临床医学进展, 2016, 6(3): 132-137. http://dx.doi.org/10.12677/ACM.2016.63024

参考文献

[1] 白向飞. 经鼻蝶入路手术治疗垂体瘤的并发症预防及原因分析[J]. 中国实用医药, 2014, 9(35): 66-67.
[2] Hardy, J. (1979) Transsphenoidal Microsurgical Treatment of Pituitary Tumours. In: Linfoot, J., Ed., Recent Advances in the Diagnosis and Treatment of Pituitary Tumour, Raven Press, New York, 375-888.
[3] James, K., Kaushik, D., Martin, H., et al. (2001) The History and Evolution of Transsphenoidal Surgery. Journal of Neurosurgery, 95, 1083.
http://dx.doi.org/10.3171/jns.2001.95.6.1083
[4] 陆书昌. 蝶窦与垂体瘤: 经蝶窦垂体瘤切除术[M]. 上海: 上海医科大学出版, 1992: 10-19.
[5] 贾永军, 徐广明. 经不同入路行垂体瘤切除术的疗效分析[J]. 中国临床神经科学, 2015, 23(2): 192-195.
[6] 李祥, 于如同, 谷佳, 等. 单鼻孔经蝶窦入路切除垂体腺瘤10年的手术体会[J]. 临床神经外科杂志, 2014, 11(6): 423-425.
[7] 田新华, 张俊卿, 陈锷, 等. 神经内镜与显微镜下单鼻孔切除垂体巨大腺瘤的疗效对比[J]. 安徽医学, 2015, 36(7): 805-808.
[8] Shou, X.F., Li, S.Q., Wang, Y.F., et al. (2005) Treatment of Pituitary Adenomas with a Transsphenoidal Approach. Neurosurgery, 56, 249-256.
http://dx.doi.org/10.1227/01.NEU.0000147976.06937.1D
[9] Papay, F.A., Benniner, M.S., Levine, H.L., et al. (1989) Trans-nasal Branseptal Endoeocpic Repair of Sphnoidal Cerebral Epinal Fluid Flstule. Otolaryngology-Head and Neck Surgery, 101, 595-597.
[10] Jankowski, R., Auque, J., Simon, C., et al. (1992) Endoscopic Pituitary Tumor Surgery. Laryngoscopy, 102, 198-202.
http://dx.doi.org/10.1288/00005537-199202000-00016
[11] 董韬, 魏学忠, 冯思哲, 等. 神经内镜与显微镜经单鼻孔蝶窦入路垂体腺瘤切除术的临床效果对比分析[J]. 中国临床神经外科杂志, 2012, 17(11): 682-684.
[12] 宋明, 张亚卓. 神经内镜与显微镜经单鼻孔蝶窦入路切除垂体腺瘤疗效比较[J]. 中华脑科疾病与康复杂志(电子版), 2014, 4(6): 31-35.
[13] 叶新运, 蒋秋华, 杨瑞金, 等. 神经导航与内镜辅助下经蝶入路切除垂体腺瘤[J]. 中华神经外科疾病研究杂志, 2015, 14(3): 269-271.
[14] Gondim, J.A., Schopes, M., de Almeida, J.P., et al. (2010) Endoscopic Endonasal Transsphenoidal Surgery: Surgical Results of 228 Pituitary Adenomas Treated in a Pituitary Center. Pituitary, 13, 68-77.
http://dx.doi.org/10.1007/s11102-009-0195-x
[15] Tabaee, A., Anand, V.K., Fraser, J.F., et al. (2009) Three-Dimensional En-doscopic Pituitary Surgery. Neurosurgery, 64, 288-295.
http://dx.doi.org/10.1227/01.neu.0000338069.51023.3c
[16] Dadashev, V. and Oyesiku, N. (2011) A Comparative Outcome Analysis of Three-Dimensional (3D) and Two-Di- mensional (2D) Endoscopic Transsphenoidal Surgery in the Treatment of Pituitary Adenomas in a Series of 115 Patients. Skull Base, 21, A125.
http://dx.doi.org/10.1055/s-2011-1274300
[17] Komotar, R.J., Starke, R.M., Raper, D.M., Anand, V.K. and Schwartz, T.H. (2012) Endoscopic Endonasal Compared with Microscopic Transsphenoidal and Open Transcranial Resection of Giant Pituitary Adenomas. Pituitary, 15, 150- 159.
http://dx.doi.org/10.1007/s11102-011-0359-3
[18] Black, P.M., Moriarty, T., Alexander, E., et al. (1997) Development and Implementation of Intraoperative Magnetic Resonance Imaging and Its Neurosurgical Applications. Neurosurgery, 41, 831-845.
http://dx.doi.org/10.1097/00006123-199710000-00013
[19] Tronnier, V.M., Wirtz, C.R., Knauth, M., et al. (1997) Intraoperative Diagnostic and Interventional Magnetic Resonance Imaging in Neurosurgery. Neurosurgery, 40, 891-902.
http://dx.doi.org/10.1097/00006123-199705000-00001
[20] 李杰, 王汉东, 杭春华, 等. 术中磁共振成像在大型侵袭性垂体瘤手术的应用[J]. 医学研究生学报, 2013, 26(1): 48-51.
[21] Wu, J.S., Shou, X.F., Yao, C.J., et al. (2009) Transsphenoidal Pitui-tary Macroadenomas Resection Guided by Polestar N20 Low-Field Intraoperative Magnetic Resonance Imaging: Comparison with Early Post Operative High-Field Magnetic Resonance Imaging. Neurosurgery, 65, 63-71.
http://dx.doi.org/10.1227/01.NEU.0000348549.26832.51
[22] Berkmann, S., Fandino, J., Muller, B., Remonda, L. and Landolt, H. (2012) Intraoperative MRI and Endocrinological Outcome of Transsphenoidal Surgery for Non-Functioning Pituitary Adenoma. Acta Neurochirurgica, 154, 639-647.
http://dx.doi.org/10.1007/s00701-012-1285-5
[23] Hlavac, M., Seitz, K., Schmidt, T. and Wirtz, R. (2011) Multimodal Naviga-tion and Intraoperative High-Field Magnetic Resonance Imaging in Transsphenoidal Surgery for Complex Pituitary Adenomas. Journal fur Neurologie, Neurochirurgie und Psychiatrie, 12, 368-371.
[24] 张威江, 鲁晓杰, 王清. MRI导航及术中成像在经蝶垂体腺瘤手术中的应用[J]. 江苏医药, 2013, 39(2): 159-162.
[25] 许志勤, 苏长保, 王任直, 等. 神经导航在经蝶垂体腺瘤手术中的应用[J]. 中华外科杂志, 2011, 49(8): 707-711.
[26] 徐福财. 经蝶窦手术与经颅手术治疗垂体肿瘤临床分析[J]. 航天航空医学杂志, 2014, 25(11): 1487-1488.
[27] Winn, H.R. 尤曼斯神经外科学. 王任直, 主译. 北京: 人民卫生出版社, 2009: 920-925.
[28] 蔡梅钦, 胡冰, 秦峰, 等. CT仿真内镜对蝶窦三维解剖的显示及在垂体瘤经蝶窦手术的应用[J]. 中国耳鼻咽喉头颈外科, 2011, 18(10): 544-547.
[29] Sinha, S. and Sharma, B.S. (2010) Giant Pituitary Adenomas—An Enigma Revisited. Microsurgical Treatment Strategies and Outcome in a Series of 250 Patients. British Journal of Neurosurgery, 24, 31-39.
http://dx.doi.org/10.3109/02688690903370305