两种手术方式治疗侵袭性垂体腺瘤的疗效和并发症比较

【目的】探讨显微镜和神经内镜下单鼻孔经蝶窦对侵袭性垂体腺瘤的手术效果。【方法】选择本院2013年1月至2013年9月收治的60例侵袭性垂体腺瘤患者作为研究对象，按照随机数字表法将患者分为两组。其中，观察组30例患者采用神经内镜下单鼻孔经蝶窦入路手术，对照组30例患者采用显微镜下单鼻孔经蝶窦入路手术，比较两组患者的治疗效果。【结果】观察组患者的手术时间、术中出血量和术后住院时间等指标均明显优于对照组患者，且两组相比较差异均具有显著性（P＜0．05），而组间的视力改善率和肿瘤全切率相比较差异无显著性（P＜0．05）。手术后，对照组患者的鼻中隔缺损率和鼻窦感染率均明显高于观察组患者，对照组患者的并发症发生率合计为73．3％（22/30），明显高于观察组20％（6/30），且两组相比较差异均具有显著性（P＜0．05）。【结论】采用神经内镜下单鼻孔经蝶窦入路术式对侵袭性垂体腺瘤具有十分显著的治疗效果，其手术时间较短，术中出血量较少，且缩短了患者术后住院时间，降低了术后并发症的发生率，有利于患者的术后恢复。

Comparison of Efficacy and Complications of Two Surgical Methods for the Treatment of Inva-sive Pituitary Adenomas

[Objective]To explore the efficacy of microscopic vs .neuroendoscopic single nostril transsphenoidal approach surgical methods for the treatment of invasive pituitary adenomas .[Methods]Totally 60 patients with invasive pituitary adenoma in our hospital from Jan .2013 to Sept .2013 were enrolled in the study . All patients were randomly divided into two groups .The observation group（ n =30） underwent neuroendo-scopic single nostril transsphenoidal approach surgery ,while the control group（ n=30） underwent microscopic single nostril transsphenoidal approach surgery .The efficacy was compared between two groups .[Results]The operation time ,intraoperative blood loss ,postoperative hospital stay and other indicators in observation group were obviously better than the control group ,and there was significant difference between two groups （ P 〈0 .05） ,but there was no significant difference in vision improvement and total tumor resection rate between two groups（ P 〉0 .05） .After operation ,nasal septum defect and sinus infection rate in control group were obviously higher than those in observation group .The incidence rate of total complications in control group was 73 .3 % （22/30） which was obviously higher than that in observation group（20% ,6/30） ,and there was significant difference（ P 〈0 .05） .[Conclusion] Neuroendoscopic single nostril transsphenoidal approach surgery for the treatment of invasive pituitary adenoma has very significant efficacy with short operation time , less intraoperative blood loss ,and can shorten postoperative hospitalization time and reduce the incidence of postoperative complications ,and is helpful for the patients＆#39;recovery .