经鼻蝶窦垂体手术中颈内动脉损伤：危险因素、处理方法。
Internal carotid artery injury during endoscopic transsphenoidal pituitary surgery: risk factors, management.
机构信息
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Neural Reconstruction, Beijing Neurosurgery Institute, Capital Medical University, Beijing, China.
出版信息
Neurochirurgie. 2024 Jan;70(1):101515. doi: 10.1016/j.neuchi.2023.101515. Epub 2023 Dec 4.
BACKGROUND
Transsphenoidal surgeons should try to avoid internal carotid artery (ICA) injury but also be prepared to manage it. We analyzed our experience with ICA injury during endoscopic transsphenoidal pituitary surgery and present associated risk factors and a management protocol.
METHODS
We retrospectively reviewed and analyzed the medical records of 1596 patients who underwent endoscopic transsphenoidal surgery for pituitary tumor resection in our institution from January 2009 to October 2022.
RESULTS
Six patients experienced an ICA injury. All received timely and effective hemostasis with immediate direct tamponade followed by endovascular treatment. No serious postoperative complications occurred.
CONCLUSIONS
We proposed a treatment plan for ICA injuries encountered during endoscopic transsphenoidal surgery and described our hemostasis process, methods of endovascular treatment, and means of postoperative follow-up in detail.
背景
经蝶窦外科医生应尽量避免颈内动脉（ICA）损伤，但也要做好应对损伤的准备。我们分析了内镜经蝶窦垂体手术中 ICA 损伤的经验，并提出相关的危险因素和处理方案。
方法
我们回顾性分析了 2009 年 1 月至 2022 年 10 月在我院接受内镜经蝶窦垂体瘤切除术的 1596 例患者的病历。
结果
6 例患者发生 ICA 损伤。所有患者均及时、有效地进行了直接压迫止血，随后进行了血管内治疗。术后无严重并发症发生。
结论
我们提出了内镜经蝶窦手术中 ICA 损伤的处理方案，并详细描述了我们的止血过程、血管内治疗方法和术后随访措施。
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