经鼻蝶入路内镜辅助垂体腺瘤切除手术临床效果分析

目的 探讨神内镜辅助下经鼻蝶入路垂体腺瘤切除手术的临床效果.方法 选取2013年1月至2015年6月于本院神经外科进行治疗的155例垂体腺瘤患者为研究对象,按照随机数字表法将以上研究对象随机分为神经内镜组和显微镜组.神经内镜组患者采用神经内镜辅助下经鼻蝶入路垂体腺瘤切除手术,而显微镜组采用显微镜辅助下经鼻蝶入路垂体腺瘤切除手术.观察记录两组患者肿瘤切除情况、术中出血量、手术时间、住院时间及术后并发症发生情况等指标;术后对两组患者进行为期6个月的随访,观察两组患者术后并发症及激素恢复情况.结果 神经内镜组患者肿瘤全切率为93.6％,显著高于显微镜组的44.2％;神经内镜组术中出血量、手术时间及住院时间分别为(60.9±4.5)ml、(85.9±10.0) min、(6.0±1.5)d,均显著低于显微镜组的(92.4±8.9)ml、(145.7±17.0) min、(9.5±2.0)d,以上差异均具有统计学意义(P＜0.05).神经内镜组术后并发症发生率显著低于显微镜组患者(P＜0.05);两组之间的激素水平好转情况差异无统计学意义(P＞0.05).结论 神经内镜辅助下经鼻蝶入路垂体腺瘤切除手术具有肿瘤全切率高、术中出血量少、手术时间短、患者术后恢复快等特点,临床效果显著,值得进一步在临床中推广应用.

Neuroendoscope-assisted microsurgery through endonasal transsphenoidal approach for pituitary adenomas

Objective To explore the clinical effect of neuroendoscope-assisted microsurgery through endonasal transsphenoidal approach for pituitary adenomas.Methods 155 patients with pituitary adenomas treated at our hospital from January,2013 to June,2015 were randomly divided into a neuroendoscope group and a microscope group according to random number table.The neuroendoscope group were treated with neuroendoscope-assisted microsurgery through endonasal transsphenoidal approach and microscope group microsurgery through endonasal transsphenoidal approach.The tumor cutting rate,intraoperative bleeding volume,operation time,length of hospital stay,and postoperative complications,etc.were observed in these two group.Results The tumor cutting rate intraoperative bleeding volume,operation time,and length of hospital stay were 93.6％,(60.9±4.5) ml,(85.9±10.0) min,and (6.0±1.5)d in the neuroendoscope group and was 44.2％,(92.4±8.9)ml,(145.7±17.0) min,and (9.5±2.0) d in the microsurgery group,with statistical differences (P＜0.05).The incidence of complications was significantly lower in the neuroendoscope group than in the microscope group patients (P＜0.05).There were no statistical differences in hormone levels between these two groups (P ＞ 0.05).Conclusions Neuroendoscope-assisted microsurgery through endonasal transsphenoidal approach for pituitary adenomas has characteristics,such as high tumor cutting rate,low intraoperative bleeding volume,short operation time,rapid recovery after surgery and is significantly effective,so it is worth being clinically generalized.