神经内镜经鼻蝶手术治疗垂体腺瘤的随机对照试验研究

目的 评价神经内镜经鼻蝶手术治疗垂体腺瘤的疗效。方法 本研究将80例垂体腺瘤患者随机分为观察组和对照组,每组各40例。观察组的患者给予神经内镜经鼻蝶手术治疗,对照组患者给予显微镜经鼻蝶手术治疗。评价两组患者的肿瘤全切率、手术时间、术后鼻腔通畅率和术后复发率、以及术后患者的催乳素、生长激素和促肾上腺皮质激素水平变化情况。结果 观察组患者的肿瘤全切率为17(42.50%)、手术时间为(88.41±10.94)min、术后鼻腔通畅率为33(82.50%)以及术后复发率为3(7.50%);对照组患者的肿瘤全切率为5(12.50%)、手术时间为(129.18±19.25)min、术后鼻腔通畅率为4(10.0%)以及术后复发率为11(27.5%)。两组比较,各指标差异有统计学意义。另外,观察组患者术后的催乳素、生长激素和促肾上腺皮质激素水平分别为(1.32±0.54)nmol/L、(0.63±0.17)nmol/L和(9.43±2.58)pmol/L,显著低于对照组的(3.13±0.85)nmol/L、(1.41±0.38)nmol/L和(16.13±3.30)pmol/L。结论 神经内镜经鼻蝶手术治疗垂体腺瘤的疗效优于显微镜经鼻蝶手术,可作为垂体腺瘤手术治疗的首选方法。

A randomized control trial of neuroendoscopic transsphenoidal surgery for treating pituitary adenomas

Objective To assess the effectiveness of neuroendoscopic transsphenoidal surgery (NTS) for the treatment of pituitary adenomas (PA). Methods A total of 80 PA patients were randomly divided into the observation group and the control group, each group 40 cases. The patients in the observation group received NTS, while the patients in the control group received microendoscopic transsphenoidal surgery (MTS). The outcomes included total tumor removal rate, operation time, postoperative nasal patency, and postoperative recurrence rate, as well as the changes in levels of prolactin, growth hormone, and adrenocorticotropic hormone in postoperative patients. Results The total tumor removal rate, operation time, postoperative nasal patency, and postoperative recurrence rate were 17(42.50%), (88.41±10.94) min, 33(82.50%), and 3(7.50%) in the observation group. In the control group they were 5(12.50%), (129.18±19.25) min, 4(10.0%), and 11(27.5%). Significant differences were found between two groups .After surgery, the levels of prolactin, growth hormone, and adrenocorticotropic hormone were (1.32±0.54) nmol/L, (0.63±0.17) nmol/L, and (9.43±2.58) pmol/L respectively in the observation group, which were significant lower than (3.13±0.85) nmol/L, (1.41±0.38)nmol/L, and (16.13±3.30) pmol/L in the control group . Conclusion The efficacy of NST is superiorto the MST for the treatment of PA, which should be recommended as the first choice for PA therapy