³úÇϼöü¼±Á¾ ÄÉÀ̽º ½ºÅ͵ð 
³úÇϼöü ¼±Á¾ ÄÉÀ̽º ÀÔ´Ï´Ù , ¹®Çå°íÂû ¹× »ç·Ê¿¬±¸ ÀÖ½À´Ï´Ù
¹® Çå °í Âû
¡× ³úÇϼöü ¼±Á¾(Pituitary adenoma)
¡× °æÁ¢Çü°ñ Á¾¾ç ÀýÁ¦¼ú(TSA, Trans-Sphenoidal Approach)
CASE STUDY
1. °£È£·Â
2. ÀÓ»ó°Ë»ç
3. Åõ¾à
4. °£È£°úÁ¤
5. ´À³¤Á¡
. °£È£·Â
F / ÀüOO 44¼¼
(1)ÀϹÝÁ¤º¸
ÀÔ¿øÀÏ - 2007.01.01
ÀÔ¿ø°æ·Î - ¿Ü·¡ °áÈ¥À¯¹Â - À¯
ÀÔ¿ø¹æ¹ý - µµº¸
ÇöÀçÁúº´»óÅ - »ó±â 44¼¼ ¿©È¯ 2~3´Þ ÀüºÎÅÍ both hands tingling, acral enlargement of
hands, feet and nose Áõ»ó ÀÖ¾î local OS ³»¿ø Å« º´¿ø °¡º¸¶ó´Â ¾ê±â µè°í ÀÌ´ë
µ¿´ë¹®º´¿ø ³»ºÐºñ³»°ú ³»¿ø ½ÃÇàÇÑ CPFT, MRI»ó pituitary adenoma Áø´Ü¹Þ°í
º»¿øÀ¸·Î refer µÇ¾î 2007³â 1¿ù 1ÀÏ NS OPD°æÀ¯ TSA removal of tumor ½ÃÇà
¹Þ±â À§ÇØ ³»¿ø.
Ű - 158cm ¸ö¹«°Ô - 64.5kg
Á÷¾÷ - ÁֺΠÁ¾±³ - ¹«
¾Ë·¹¸£±â - ¹«
(2)°¡Á··Â
¾øÀ½
(3)°ú°Åº´·Â ¹× ÃÖ±Ù Åõ¾à
¾øÀ½
(4)½Åü»çÁ¤
Àü¹ÝÀû »óÅ : ¾çÈ£
±âÇü - ¾øÀ½ µ¿Åë - ¾øÀ½ ½Ä¿å - º¸Åë
üÁߺ¯È -¾øÀ½ ¼ö¸é»óÅ - 8h/d
¼Òº¯ - 5~6ȸ/d ´ëº¯ - 1ȸ/d
¼ÒȱâÀå¾Ö: ¾øÀ½
¼øÈ¯±âÀå¾Ö: ¾øÀ½ (ºÎÁ¾ - ¾øÀ½)
û·ÂÀå¾Ö - ¾øÀ½ ¸í¹éÇÑ ±âÇü - ¾øÀ½
½Ã·ÂÀå¾Ö - ¾øÀ½
¸¶ºñ ¹× ¼è¾à - ¾øÀ½ ÀÇ»ç¼ÒÅë - °¡´É
°èÅë¹®Áø R.O.S.: A/N/V(-/+/+)
H/D(+/+)
Nasal obs/rhinorrhea(+/-)
Infertility (-)
Amenorrhea (-) menorrhagia (+)
Polyuria (+)
polydypsia (+)
Axillary hair loss/pubic hair loss(-/-)
Livido decrease (-)
Galactorrhea (-)
Acromegaly (+)
2. ÀÓ»ó°Ë»ç
°Ë »ç
Á¤ »ó Ä¡
1/3
OP day
1/4
OP 1
ÀÓ »ó Àû ÀÇ ÀÇ
Áõ °¡
°¨ ¼Ò
CBC
RBC
M:450-610¸¸/§¡
F:380-530¸¸/§¡
315¸¸
289¸¸
½ÅÀåÁúȯ, ÆóÁúȯ, Èí¿¬, Àú»ê¼ÒÁõ, Å»¼öÁõ
¿ëÇ÷¼º ºóÇ÷, Àç»ýºÒ·®¼º ºóÇ÷
WBC
4500-11000/§¡
13370
11270
±Þ¼º°¨¿°, ¹éÇ÷º´
Àç»ýºÒ·®¼º ºóÇ÷, ¹ÙÀÌ·¯½º °¨¿°
Platelet count
10¸¸-40¸¸/§¡
24.2¸¸
25.3¸¸
¸¸¼º¹éÇ÷º´
°ñ¼ö±â´ÉÀúÇÏ, °¨¿°Áõ
hemoglobin
M:13-18g/dl
F:11.5-16.5g/dl
10
9.3
Ç÷»ö¼ÒÁõ
ºóÇ÷, ½ÅÀå, °£ÀåÁúȯ
hematocrit
M:40-54%
F:36-47%
28.6
26.1
Å»¼öÁõ, ´ÙÇ÷±¸Ç÷Áõ
ºóÇ÷
WBC
Neutrophil
40-74%
91.7
92.8
Lymphocyte
19-48%
6.2
µîµî ÀÔ´Ï´Ù

