摘要
目的探讨垂体腺瘤经鼻蝶显微手术中应用自体骨修复重建鞍底、蝶窦的临床疗效及术后并发症。方法回顾性分析2016年01月至2018年12月期间就诊郑州大学人民医院神经外科行经鼻蝶入路显微手术治疗的垂体腺瘤病例共213例,其中术中未行鞍底、蝶窦修复重建病例97例(对照组),术中行自体骨鞍底、蝶窦修复重建病例116例(观察组)。比较两种手术方式临床疗效及术后脑脊液漏及逆行性感染的发生率。结果两组术前MRI、CT检查提示鞍底、蝶窦骨质侵犯破坏程度无明显差异(P>0.05);两组患者肿瘤切除程度相比无明显差异(P>0.05);而术后临床疗效改善观察组明显优于对照组(P<0.05);观察组术后脑脊液漏发病率远低于对照组(χ^2=8.691,P=0.003);观察组逆行性感染的发病率也明显低于对照组(χ^2=6.242,P<0.05)。结论经鼻蝶垂体腺瘤显微手术切除术中应用自体骨修复重建鞍底、蝶窦,恢复正常解剖结构,显著降低术后脑脊液漏、逆行性感染的发生率,患者术后临床疗效显著。
Objective To investigate the clinical effect and postoperative complications of transsphenoidal microsurgery for pituitary adenoma and reconstruction of sellar floor and sphenoid sinus with autologous bone.Methods A retrospective analysis was made on 213 cases of sellar lesions treated by transsphenoidal approach in our department from January 2016 to December 2018.Among them,97 cases(control group)did not undergo sellar floor and sphenoid sinus repair and reconstruction during the operation,and 116 cases(observation group)underwent sellar floor and sphenoid sinus repair and reconstruction during the operation.To compare the clinical efficacy and incidence of postoperative complications of the two surgical methods.Results There was no significant difference between the two groups in preoperative CT examination of sellar floor and sphenoid sinus bone destruction(P>0.05).The postoperative curative effects of the two groups were similar(P>0.05).The improvement of clinical symptoms after operation was better in the observation group than that in the control group(P<0.05).The incidence of postoperative cerebrospinal fluid leakage in the observation group is much lower than that in the control group(χ^2=8.691,P<0.05).The incidence of retrograde infection in the observation group was also significantly lower than that in the control group(χ^2=6.242,P=<0.05).Conclusion Reconstruction of sellar floor and sphenoid sinus with autologous bone in transsphenoidal microsurgery can restored normal anatomical structure,significantly reduce the incidence of postoperative complications and improve efficacy of patients.
作者
高玉帅
冯淼淼
步星耀
闫兆月
胡森
禹金良
盛致远
GAO Yu-shuai;FENG Miao-miao;BU Xing-yao;YAN Zhao-yue;HU sen;YU Jin-liang;SHENG Zhi-yuan(Department of Neurosurgery,People’s Hospital of Zhengzhou University,Henan Provincial People’s Hospital,Zhengzhou 450003,China)
出处
《医药论坛杂志》
2020年第3期1-4,8,共5页
Journal of Medical Forum
基金
河南省医学科技攻关计划省部共建项目(122102310151,201601016)。
关键词
垂体腺瘤
经鼻蝶入路
自体骨
鞍底蝶窦重建
脑脊液漏
Pituitary adenoma
Transsphenoidal
Autogenous bone
Reconstruction of sellar fundus and sphenoid sinus
Cerebrospinal fluid leakage
