垂体腺瘤经鼻蝶入路切除术后复发情况及影响因素研究

目的 探讨垂体腺瘤(PA)经鼻蝶入路切除术后复发情况及影响因素。方法 回顾性分析2016年10月至2022年12月于自贡市第一人民医院行经鼻蝶入路切除术治疗的66例PA患者的临床资料，根据术后复发情况进行分组，将复发的17例患者纳入试验组，未复发的49例患者纳入对照组。对比两组患者的临床资料并采用二元Logistic回归法分析影响患者复发的危险因素。结果 随访期间共有17例患者出现术后复发，复发率为25.76%。单因素分析结果显示，两组在肿瘤大小、肿瘤侵袭性、手术方式和肿瘤切除程度方面比较，差异有统计学意义(P<0.05);二元Logistic回归分析结果显示，侵袭性肿瘤OR=7.996,95%CI:1.050～60.880]是影响患者术后复发的独立危险因素，而神经内镜手术方式OR=0.081,95%CI:0.008～0.846]和肿瘤次全切OR=0.044,95%CI:0.003～0.612]、全切除OR=0.037,95%CI:0.002～0.655]是影响患者术后复发的独立保护因素。结论 PA经鼻蝶入路切除术后复发风险较高，肿瘤性质、手术方式选择和肿瘤切除情况可能是...

Study on the recurrence and influencing factors of pituitary adenoma after transnasal transsphenoidal resection

Objective To explore the recurrence of pituitary adenoma(PA)after resection via transsphenoidalapproach and the influencing factors.Methods The clinical data of 66 PA patientswho underwent PA resection viatransphenoidal approach in Zigong First Peoples hospital from October 2016 to December 2022 were retrospectivelyanalyzed.According to the follow-up results,17 patients with recurrence were included in the experimental group,and 49 patients without recurrence were included in the control group.The clinical data of the two groups werecompared.And the risk factors of recurrence were analyzed by binary Logistic regression.Results During thefollow-up period,17 of the 66 patients had postoperative recurrence,with a recurrence rate of 25.76%.Univariateanalysis showed that there were significant differences between the two groups in tumor size,tumor aggressiveness,surgical methods and tumor resection degree(P<0.05).Binary Logistic regression analysis showed that invasivetumor OR=7.996,95%CI:1.050-60.880]was an independent risk factor for postoperative recurrence in PApatients,while neuroendoscopic surgery OR=0.081,95%CI:0.008-0.846],subtotal resection OR=0.044,95% CI:0.003-0.612]and total resection OR=0.037,95%CI:0.002-0.655]were independent protective factors forpostoperative recurrence.Conclusion The recurrence risk of PA after transsphenoidal resection is high.The natureof tumor,surgical method,and tumor resection degree may be important factors affecting the postoperative recurrence of PA.