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Echocardiographic left ventricular function in type 2 diabetes evaluation


culation, 2001,103 (1): 1024 Fu Xiaoying, Zhou Yan, Ma Shuping and so on. Macrovascular complications in type 2 diabetes related factors multiple regression analysis. Chinese Journal of Diabetes, 2002,10 (2): 101 (Received 2006-03-29 Revised 2006-01-04) (Editor Lien Jiang) who single-nostril transsphenoidal resection of pituitary tumors reported 61 cases of pituitary tumor Keywords ; Neurosurgery Words R736.41 Chinese books and materials and methods of data Boguo Yun Zhou Yi Li Ying Li Mu Du Hongsheng Ping Xuequan frequency 61 patients, 36 males and 25 females, aged 23 to 67 years, mean 39 years, duration of 2 to 22 months months, hospitalized 12 to 40 days, an average of 18 days. Menstrual disorders, amenorrhea, lactation in 22 cases, 21 cases of acromegaly, sexual dysfunction in 15 patients, decreased beard, hair loss, 8 cases 2O cases of vision loss, double vision 46 patients with temporal hemianopsia. Endocrine examination of 26 cases of elevated GH, PRI increased in 29 cases. Immunohistochemistry 26 cases diagnosed as growth hormone adenoma, 24 cases of prolactinomas, nonfunctioning adenomas l1 cases. Sella sella spherical X-ray film showed enlarged sellar thinning, after clinoid, saddle back 47 cases of bone absorption. CT and MRI showed 47 cases of optic chiasm compression, pituitary stalk displacement in 54 cases, of which broke into the sphenoid sinus l1 cases. Pituitary tumor diameter l ~ 4cm. Surgical procedures: anesthesia, supine position, head thrown back 15. To fill sliver bilateral ephedrine nasal saline nasal contraction, into a single nostril mouth speculum to the level of butterflies, at the root of the nasal septum to the contralateral bone to break. The nasal mucosa with nasal bone into the contralateral, stripping butterfly at the mouth mucosa, violence and the sphenoid sinus openings mole butterfly mouth to open the sphenoid bone logo, open the sphenoid sinus, sphenoid sinus mucosa removed, confirm the saddle at the end position ( available when necessary, C-Arm) and open the sellar floor, Carefully remove the tumor, postoperative use of gelatin sponge, brain glue ear sellar repair, if repair of cerebrospinal fluid leakage must be tight to avoid rhinorrhea, such as larger tumor size, tumor resection cavity to be filled with the residual amount of fat organizations, to avoid the empty sella syndrome. Gauze nasal cavity, postoperative antibiotics and other symptomatic treatment. 2 Results 61 patients were surgical cases in 6O smooth, accurate positioning. 3 ~ 1O days after the first review, GH, PRI have different levels of decline. There were 17 cases of diabetes insipidus, urinary thiophene and Hydrochlorothiazide given pituitrin and other treatment for 3 to 14 days remission. 5 cases of postoperative cerebrospinal fluid rhinorrhea, lumbar drainage lines 5 to 7 days rhinorrhea disappeared. Followed up 1 to 3 months, visual acuity improved to varying degrees field of vision. Near total resection of tumor in 54 cases, subtotal in 6 cases. Open the saddle at the end only 1 case when a large number of ferocious cut dural venous bleeding, considered abnormal cavernous sinus between the developed due to hemostasis were suspended after the surgery. 1O days after surgery, and then the screen pterional craniotomy for tumor resection line, the successful surgery, endoscopic total resection of tumor, postoperative pathology of GH adenomas, Ia wound healing. 3 Discussion gasification conditions are good for the transsphenoidal micro, small and medium-sized pituitary tumor via transsphenoidal approach currently used has become a common operation, large or giant pituitary tumors in which surgical approach is better is not yet uniform. Selection of clinical indications for transsphenoidal surgery is mainly: ① sella expanded significantly, mostly in the saddle within the tumor; ② chiasm pituitary tumor front; ③ pituitary tumor extended to the saddle, but not was dumbbell-shaped, not to the parasellar invasion, and the soft texture of the tumor imaging tips; ④ pituitary tumor usually 6cm, but the saddle, the saddle shape can still be extended by the side; ⑤ elderly, the infirm who can not tolerate craniotomy . Contraindications are rhinitis, sphenoid sinusitis, pituitary tumor laterally, the frontal end of the back side saddle with poor development and sphenoid gasification. In general, transsphenoidal only on the slope in storms mole, and for violations of the middle and lower slopes of the pituitary adenoma violence mole difficulties, there is the blind angle, the tumor tend to have a residual, and easy to damage the surrounding vital structures, perioperative removal difficult. The most serious complication of surgery is the lateral wall of the sphenoid sinus carotid artery, optic nerve damage. Patients must pay attention to sellar bone window should not be too big to grasp the side of the storm sound l} range. Postoperative cerebrospinal fluid rhinorrhea lumbar drainage may be as early as possible. The key is to determine the presence or absence of rhinorrhea, nasal large amount of fluid leakage diagnosis is not difficult, and the nose smaller amount of fluid leakage in the diagnosis mainly depends on outflow of fluid rhinorrhea biochemistry. (Received 200603-17 Revised 2006-01-0 (Editor Lien Jiang) Author: 300072, Tianjin First Central Hospital Department of Neurosurgery (Zhou Yi frequency, Li Ying, the country goes, Li Mu, Du Hongsheng, Fengxue Quan) l Nankai University School of Medicine postgraduate courses (weeks Yi frequency, Li Ying, the National cloud)