神经导航在显微经鼻蝶垂体腺瘤切除术中的应用价值

目的探讨神经导航在显微经鼻蝶垂体腺瘤切除术中的应用价值。方法将76例垂体腺瘤病人分为导航组36例和非导航组40例,对比手术路径和定位准确性、手术时间、手术效果及并发症发生情况。结果导航组手术时间平均115min,手术路径及定位准确;肿瘤全切除27例,次全切除6例,大部分切除3例。非导航组手术时间平均110min,术中定位困难1例;肿瘤全切除29例,次全切除7例,大部分切除3例。两组手术时间、全切除率差异均无统计学意义（P〉0.805）,而手术并发症总体发生率差异有统计学意义（P〈0.05）。结论神经导航经鼻蝶垂体腺瘤切除术定位准确,可避免严重并发症的发生,扩展手术适应证;但并不能提高肿瘤切除率。

Applied value of neuronavigation in endonasal transphenoidal microsurgery for pituitary adenoma

Objective To explore the applied value of neuronavigation in the resections of pituitary adenoma via endonasal transsphenoidal approach. Methods Seventy-six patients who underwent pituitary adenoma surgery via endonasal transphenoidal approach were divided into navigation group （n = 36） and non-navigation group （n = 40）. The accuracy of the approach and localization, operative time, surgical efficacy and complications were compared. Results The operative time was 115 min, with accurate approach and localization, in the navigation group and about 110 min, with difficult localization of 1 case in the non-navigation group. Total tumor resection was achieved in 27 and 29 patients, subtotal resection in 6 and 7, and partial resection in 3 and 3 in the navigation group and the non-navigation group respectively, with no difference in the total resection rate between the two groups （P 〉0.805）, while the postoperative complication rate showed a group difference （P〈0.05）. Conclusion The neuronavigation could assure the accurate location without severe complications and expand indications for the surgery via endonasal transphenoidal approach, but could not improve tumor resection rate.