摘要
目的探讨神经内镜与显微镜经鼻蝶入路切除垂体瘤的短期疗效和预后。方法选取2020年10月至2021年10月期间周口骨科医院收治的78例垂体瘤患者,按数字表法随机分为研究组(39例神经内镜经鼻蝶入路切除垂体瘤)和对照组(39例显微镜经鼻蝶入路切除垂体瘤)。对比两组疗效、手术相关指标,治疗前后嗅觉、视觉功能、激素水平、两组并发症发生率以及术后一年复发率和生活质量评分。结果研究组疗效有效率(94.87%)显著高于对照组(76.92%),差异有统计学意义(P<0.05)。研究组手术耗时、术中出血量、术后住院时长均低于对照组,差异有统计学意义(P<0.05)。术后1个月,两组嗅觉识别阀值均高于术前,且对照组高于研究组,差异有统计学意义(P<0.05);术后1个月,两组视野平均缺损均低于术前,研究组低于对照组,差异有统计学意义(P<0.05);术后1个月,两组加权视野指数均高于术前,研究组高于对照组,差异有统计学意义(P<0.05)。术后1个月,两组泌乳素、生长激素、促肾上腺皮质激素水平均低于术前,且研究组低于对照组,差异有统计学意义(P<0.05)。研究组并发症发生率(10.26%)低于对照组(30.77%),差异有统计学意义(P<0.05)。研究组一年复发率(5.13%)低于对照组(25.64%),差异有统计学意义(P<0.05);术后一年,两组生活质量评分均高于术前,且研究组高于对照组,差异有统计学意义(P<0.05)。结论神经内镜经鼻蝶入路切除垂体瘤较显微镜疗效更佳,并发症发生率和复发率更低低,可改善患者嗅觉、视觉功能、激素,提高生活质量。
Objective To investigate the short-term effect and prognosis of transnasal sphenoidal approach resection of pituitary tumor by neuroendoscopy and microscope.Methods A total of seventy-eight patients with pituitary tumors admitted to zhoukou orthopaedic hospital October 2020 to October 2021 were randomly divided into the study group(39 patients with pituitary tumors removed by endoscopic transnasal transsphenoidal approach)and the control group(39 patients with pituitary tumors removed by endoscopic transnasal transsphenoidal approach)according to the digital table method.The curative effect,surgical related indexes,olfactory function,visual function and hormone level before and after treatment were compared between the two groups;The complication rate,one-year postoperative recurrence rate and quality of life score of the two groups were compared.Results The total effective rate of the study group(94.87%)was higher than that of the control group(76.92%),the difference is statistically significant(P<0.05);The operation time,intraoperative bleeding and postoperative hospital stay in the study group were lower than those in the control group,the difference is statistically significant(P<0.05);One month after operation,the olfactory recognition threshold in the two groups were higher than those before operation,and those in the control group were higher than those in the study group,the difference is statistically significant(P<0.05);One month after surgery,the average visual field defect in both groups was lower than before surgery,and the study group was lower than the control group,with a statistically significant difference(P<0.05);One month after surgery,the weighted visual field index of both groups was higher than before surgery,and the study group was higher than the control group,with a statistically significant difference(P<0.05);One month after surgery,the levels of prolactin,growth hormone,and adrenocorticotropic hormone in both groups were lower than before surgery,and the study group was lower than the control group,with statistically significant differences(P<0.05).The incidence of complications in the study group(10.26%)was lower than that in the control group(30.77%),and the difference was statistically significant(P<0.05).The one-year recurrence rate of the study group(5.13%)was lower than that of the control group(25.64%),and the difference was statistically significant(P<0.05);The quality of life in the two groups after 1 year was higher than that before operation,and that in the study group was higher than that in the control group,the difference is statistically significant(P<0.05).Conclusion Neuroendoscopic transnasal transsphenoidal approach for pituitary tumor resection has better curative effect than microscope,lower complication rate and recurrence rate,and can improve patients’sense of smell,visual function,hormone and quality of life.
作者
马文涛
李改峰
丁大领
MA Wentao;LI Gaifeng;DING Daling(Department of Neurosurgery,Zhoukou Orthopedic Hospital,Zhoukou Henan 466000,China;Department of Neurosurgery,Zhengzhou University First Affiliated Hospital,Zhengzhou Henan 450000,China)
出处
《临床研究》
2024年第3期7-11,共5页
Clinical Research
关键词
垂体瘤
神经内镜
显微镜
经鼻蝶入路
复发率
pituitary tumor
neuroendoscopy
microscope
transnasal sphenoidal approach
recurrence rate
