神经内镜引导下经鼻蝶窦入路切除垂体瘤的临床研究

目的：观察神经内镜下经单鼻孔蝶窦入路手术切除垂体瘤的临床疗效及安全性。方法：选取我院197例经单鼻孔蝶窦入路手术的垂体瘤患者，其中神经内镜下治疗的患者为105例(神经内镜组)，显微镜下治疗的患者为92例(显微镜组)。比较两组手术时间、术中出血量、1年后随访复发率、术后住院时间与术后并发症、肿瘤全切率、内分泌激素下降情况。结果：神经内镜组术中出血量、手术时间、术后住院时间、1年后随访复发率、术后并发症(尿崩症、低钾血症、视力障碍、颅内血肿、鼻腔出血)发生率均低于显微镜组；肿瘤全切率、内分泌激素下降率均高于显微镜组，差异具有统计学意义(P<0.05)。结论：神经内镜辅助下行经鼻蝶窦入路垂体瘤切除术效果显著，具有手术时间短、术中出血量少、术后住院时间短，且并发症发生率低，安全性更强，值得在临床中推广。

Clinical study of endoscopic sinus approach for pituitary tumor resection

Objective:To observe the clinical efficacy and safety of endoscopic sinus surgery for pituitary adenomas. Methods: 197 cases with pituitary adenoma treated by single nasal endoscopic surgery were selected in our hospital, including 105 cases treated by endoscopic surgery (endoscopic group) and 92 cases treated by microscope surgery (microscope group). hTe operation time, blood loss, total tumor resection rate, postoperative hospital stay and postoperative complications, 1-year follow-up recurrence rate and decrease ratio of endocrine hormones were compared between the two groups.Results: hTe bleeding volume, operative time, hospitalization time, 1 year recurrence rate and postoperative complications (diabetes insipidus, low potassium hyperlipidemia, visual impairment, intracranial hematoma, nasal bleeding) occurrence rate were lower than those of the microscope group; total tumor removal rate and endocrine hormone reduction rate were higher than those of the microscope group, the difference was statistically signiifcant (P<0.05).Conclusion: hTe clinical effcacy of endoscope assisted by nasal transsphenoidal pituitary adenoma resection operation is remarkable, with shorter operation time,intraoperative blood loss less, postoperative hospitalization time, stronger safety, and the complication rate is low; it is worth in clinical promotion.