摘要
目的比较神经内镜与显微镜手术切除垂体瘤的效果及安全性。方法选取2015年7月至2023年5月河南中医药大学第一附属医院收治的68例垂体瘤为研究对象,其中32例接受经鼻碟神经内镜下垂体瘤切除术,36例接受经鼻碟显微镜下垂体瘤切除术。分析两组肿瘤全切率、视力视野改善率、激素水平术后缓解率、围手术期指标及术后并发症。结果神经内镜组肿瘤全切28例,高于显微镜组(23例)(P<0.05)。对于Knosp 0~2级垂体瘤,神经内镜组肿瘤全切率高于显微镜组,但差异无统计学意义(P>0.05);对于Knosp 3~4级肿瘤,神经内镜组肿瘤全切率高于显微镜组(P<0.05)。神经内镜组视力视野改善率高于显微镜组(P<0.05),神经内镜组激素术后缓解率高于显微镜组,但差异无统计学意义(P>0.05)。神经内镜组患者住院时间短于显微镜组,术中出血量低于显微镜组(P<0.05),两组手术时间差异无统计学意义(P>0.05)。神经内镜组总并发症发生率低于显微镜组(P<0.05)。结论神经内镜经鼻碟手术治疗垂体瘤安全有效,可优化围手术期指标,提高肿瘤全切除率,减少并发症。
Objective To compare the effectiveness and safety of neuroendoscopic and microsurgical resection of pituitary tumors.Methods A total of 68 cases of pituitary adenomas treated in the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from August 2015 to June 2023 were selected as the research objects,of which 32 cases underwent transnasal disc neuroendoscopic resection of pituitary aneurysm,and 36 cases underwent transnasal disc microscopic pituitary adenectomy.Analyze the total tumor resection rate,visual field improvement rate,hormone level postoperative response rate,perioperative indicators,and postoperative complications in two groups.Results There were 28 cases of total tumor resection in the neuroendoscopic group and 23 cases in the microscopic group,and the total tumor resection rate in the endoscopic group was higher than that in the microscopic group(P<0.05).For Knosp grade 0-2 pituitary tumors,The neuroendoscopic group can achieve a higher total tumor resection rate than the microscopic group,but the difference was not statistically significant(P>0.05),and for Knosp grade 3-4 tumors,compared with the microscopic group,the neuroendoscopic group can achieve a higher total tumor resection rate(P<0.05).Compared with the microscopic group,the neuroendoscopic group has higher improvement rate in visual field and vision(P<0.05),at the same time,the neuroendoscopic group had a higher postoperative hormone relief rate,but the difference was not statistically significant(P>0.05).The patients in the neuroendoscopic group had shorter hospital stay and less intraoperative bleeding(P<0.05),and there was no significant difference in operation time between the two groups(P>0.05).The neuroendoscopic group has a lower overall incidence of complications compared to the microscopic group(P<0.05).Conclusion Neuroendoscopic transnasal disc surgery for pituitary tumors is safe and effective,can optimize perioperative indicators,improve total tumor resection rate,and reduce complications.
作者
简历
杨建
李鹏飞
徐可
JIAN Li;YANG Jian;LI Pengfei;XU Ke(Department of Neurosurgery,the First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450000,China)
出处
《河南医学研究》
CAS
2024年第6期1015-1018,共4页
Henan Medical Research
关键词
神经内镜
显微镜
垂体瘤
疗效
安全性
neuroendoscopic
microscopic
pituitary adenoma
effectiveness
safety
