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神经内镜下库欣病经蝶入路手术治疗疗效(附18例分析)

Surgical Treatment Efficacy of Cushing’ Disease under the Neuro-endoscopy by Transsphenoidal Approach: Analysis of 18 Cases

【作者】 石海平

【导师】 张庭荣;

【作者基本信息】 新疆医科大学 , 外科学, 2010, 硕士

【摘要】 目的:评价神经内镜下库欣病经蝶入路手术治疗的疗效并探讨如何提高库欣病治疗的缓解率。方法:回顾性分析我科2007年7月至2010年3月开展神经内镜手术以来,经蝶入路手术治疗的18例库欣病患者的术后、随访期的临床表现、内分泌检查结果,评价患者的早期缓解率、早期并发症及随访期缓解率及并发症发生率。结果:16例患者表现为术后早期完全缓解,1例患者仅表现为部分缓解,1例无效者进一步行伽马刀治疗。随访期中,17例患者均表现为完全缓解,垂体放疗者呈部分缓解。结论:经蝶手术是治疗库欣病的最佳方法,围手术期可以通过多种途径有效地提高库欣病治疗的缓解率,神经内镜的成熟应用使得经蝶手术治疗库欣病的方法更加优化。

【Abstract】 Objective: To evaluate surgical treatment efficacy of Cushing’disease under the neuro-endoscopy by transsphenoidal approach and to investigate how to raise remission rate of Cushing’disease treatment. Methods: Retrospectively analyzed clinical manifest- tation and endocrine examination of postoperative and follow-up period of 18 cases with Cushing’disease under the neuro-endoscopy by transsphenoidal approach from July 2007 to March 2010 in my neurosurgery department and assessed early- remission and complication as well as the remission and complication in follow-up period. Results: 16 cases present total-early-remission. 1 cases present only part-remission, 1 case present inefficacy and accepts Gamma Knife surgery. during follow-up period, 17 cases obtain satisfactorily total-remission, the case who accepted Gamma Knife surgery obtain part-remission. Conclusion: Transsphenoidal surgery is the preferred treatment modality for Cushing’disease. we can efficaciously raise remission rate of Cushing’disease treatment by many ways surrounding the operations. the proficiency of neuro-endoscope therapy mades transsphenoidal surgery treatment for Cushing’disease optimized.

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