摘要
目的:对比神经内镜与显微镜经鼻蝶手术治疗垂体瘤的临床效果。方法:选取2016年1月-2018年12月本院收治并接受手术治疗的垂体瘤患者51例,按手术方法不同分为对照组(n=21)和观察组(n=30)。对照组应用经鼻蝶显微镜垂体瘤切除术,观察组应用经鼻蝶神经内镜垂体瘤切除术。观察并比较两组手术情况、肿瘤全切除率、手术前后的视觉功能、激素水平及并发症发生情况。结果:观察组手术时间、术中出血量和总住院时间均明显少于对照组(P<0.05);观察组肿瘤全切除率(95.24%)明显高于对照组(73.33%),差异有统计学意义(P<0.05);手术后,两组加权视野指数高于治疗前,而视野平均缺损和模式标准差均低于手术前(P<0.05)。观察组加权视野指数、视野平均缺损和模式标准差均优于对照组(P<0.05)。手术后,两组泌乳素、生长激素和促肾上腺皮质激素均低于手术前(P<0.05);观察组泌乳素、生长激素和促肾上腺皮质激素均低于对照组(P<0.05);观察组并发症发生率(10.00%)低于对照组(38.10%),差异有统计学意义(P<0.05)。结论:对于垂体瘤患者,神经内镜经鼻蝶手术治疗效果优于显微镜经鼻蝶手术,可显著提高肿瘤全切除率,促进患者视觉功能的恢复,降低激素水平,值得临床推广应用。
Objective: To compare the clinical effects of endoscopic and microscopic transsphenoidal surgery for pituitary tumor. Method: From January 2016 to December 2018, 51 patients with pituitary tumor admitted to our hospital and received surgical treatment were selected. According to different surgical methods, they were divided into control group(n=21) and observation group(n=30). The control group was treated with transsphenoidal microscopic pituitary tumor resection, while the observation group was treated with transsphenoidal endoscopic pituitary tumor resection. The surgical status, total tumor removal rate, visual function, hormone levels before and after surgery and complications of the two groups were observed and compared. Result: The surgery time, intraoperative bleeding volume and total hospitalization time of the observation group were significantly lower than those of the control group(P<0.05). The total tumor resection rate of the observation group(95.24%) was significantly higher than that of the control group(73.33%), the difference was statistically significant(P<0.05). After surgery, the weighted visual field index of the two groups was higher than that before treatment, but the mean visual field defect and mode standard deviation were lower than those before surgery(P<0.05). The weighted visual field index, mean visual field defect and mode standard deviation of the observation group were better than those of the control group(P<0.05). After surgery, prolactin, growth hormone and corticotrophin in both groups were lower than those before surgery(P<0.05). Prolactin, growth hormone and corticotrophin in the observation group were lower than those in the control group(P<0.05). The incidence of complications in the observation group(10.00%) was lower than that in the control group(38.10%), the difference was statistically significant(P<0.05). Conclusion: For patients with pituitary tumor, endoscopic transsphenoidal surgery is superior to microscopic transsphenoidal surgery, which can significantly improve the total tumor removal rate, promote the recovery of patients’ visual function, and reduce the hormone level. It is worthy of clinical promotion and application.
作者
黄斌
刘保国
肖罡
田硕
何黎明
张龙
宋启星
钟兵
HUANG Bin;LIU Baoguo;XIAO Gang;TIAN Shuo;HE Liming;ZHANG Long;SONG Qixing;ZHONG Bing(Yuebei People’s Hospital,Shaoguan 512026,China)
出处
《中国医学创新》
CAS
2019年第34期19-22,共4页
Medical Innovation of China
基金
韶关市卫生计生科研计划项目(Y17038)
关键词
经鼻蝶显微镜垂体瘤切除术
经鼻蝶神经内镜垂体瘤切除术
垂体瘤
Transsphenoidal microscopic pituitary tumor resection
Transsphenoidal endoscopic pituitary
tumor resection Pituitary tumor
作者简介
通信作者:黄斌。
