显微镜与神经内镜下经蝶窦手术切除垂体腺瘤的临床对比分析

目的比较单鼻孔经蝶窦手术入路切除垂体腺瘤的手术中使用显微镜与神经内镜的效果。方法选取本院收治的70例单鼻孔经蝶窦手术入路切除垂体腺瘤患者资料,根据治疗方法不同分为两组,其中32例采用显微镜治疗下治疗（M组）,38例采用内镜下治疗（E组）,比较两组手术情况、术后肿瘤残留率,术中、术后并发症情况。结果两组手术时间比较,差异有统计学意义（χ2=5.214,P〈0.01）;术后影像检查显示肿瘤残留率差异无统计学意意义（χ2=0.127,P〉0.05）;术中、术后脑脊液瘘、术后尿崩等并发症发生率差异无统计学意义（χ2=0.174、0.203、0.319,P〉0.05）;两组术后住院时间比较,差异无统计学意义（χ2=0.042,P〉0.05）。结论神经内镜下单鼻孔经蝶窦手术入路切除垂体腺瘤显微镜与显微镜下手术效果基本一致,神经内镜下手术具有微创优势,将在神经外科手术中进一步普及。

Clinical comparison of pituitary adenoma resection with single nostril sphenoid sinus surgical approach under endoscopic and microscopy

Objective To compare the effect of pituitary adenoma resection with single nostril sphenoid sinus surgical approach under microscope and neuroendoscopy.Methods 70 cases of pituitary adenoma patients were selected who were given pituitary adenoma resection with single nostril sphenoid sinus surgical approach in our hospital,All patients were divided into two groups according to the different treatment methods,of which 32 cases were given pituitary adenoma resection under microscope（group M）,38 cases were given pituitary adenoma resection under（group E）;the surgery situation,postoperative residual tumor rate,intraoperative and postoperative complications of two groups were compared.Results The operation time of two groups compared,the difference was statistically significant（χ2 = 5.214,P 0.01）;the postoperative imaging showed that residual tumor rate of two groups was not significantly different（χ2 = 0.127,P 0.05）;intraoperative and postoperative cerebrospinal fluid fistula,postoperative diabetes insipidus complication rate of two groups was no significantly different（χ2 = 0.174,0.203,0.319,P 0.05）,the postoperative hospital stay time of two groups was no significant different（χ2 = 0.042,P 0.05）.Conclusion The effect of pituitary adenoma resection with single nostril sphenoid sinus surgical approach under microscope and neuroendoscopy is basically the same,but endoscopic surgery has minimally invasive advantages,so it will be further popularized in neurosurgery.