加速康复外科在经鼻蝶手术治疗垂体腺瘤中的应用  

Fast track surgery in transsphenoidal surgery for pituitary adenomas

作　　者：王友伟[1] 马驰原[1] 王汉东[1] 杭春华[1] 成惠林[1] 樊友武[1] 孙康健[1] 李杰[1] 潘云曦[1] 李劲松[1] 王圣[1] 

机构地区：[1]南京军区南京总医院神经外科,江苏南京210002

出　　处：《中华神经外科疾病研究杂志》2014年第2期113-117,共5页Chinese Journal of Neurosurgical Disease Research

基　　金：国家自然科学基金资助项目(30801178)

摘　　要：目的探讨加速康复外科(FTS)在垂体瘤经鼻蝶手术患者围手术期的应用价值,提出初步的临床治疗路径。方法回顾性分析我科自2009年1月至2012年1月经手术和病理证实为垂体瘤并入选研究的患者189例,均接受经鼻蝶入路垂体瘤切除术,其中82例患者采用加速康复外科临床路径作为研究组,其余107例患者采用传统临床路径作为对照组。随访至术后3个月,采用临床对照研究,比较两组患者术前准备时间、肿瘤切除率、术后住院时间、术中脑脊液漏、术后主要并发症发生率及总住院时间。结果加速康复外科组较传统组术前准备时间、术后住院时间及总住院时间明显缩短,术中脑脊液漏及术后脑脊液漏发生率明显减少,而肿瘤切除率、术后尿崩发生率无显著性差异。结论加速康复外科治疗理念更利于接受经鼻蝶手术的垂体瘤患者的治疗。Objective The application of fast track surgery in transsphenoidal surgery for pituitary adenomas is investigated and the preliminary clinical pathway is put forward.Methods A total of 189 cases of pituitary adenoma diagnosed by surgery and pathology were included in the study.All the patients underwent transsphenoidal surgery from January 2009 to January 2012,in which 82 patients were treated with fast track surgery （FTS） protocol,and 107 patients were treated with traditional protocol （control group）.All the patients were followed up for 3 months postoperation.The outcomes of patients in FTS group and traditional group were compared,including preoperative time,tumor removal rate,postoperative hospitalization time,intraoperative cerebrospinal fluid leakage,postoperative complications,and total lengths of stay.Results The preoperative time,shorter postoperative hospitalization time and total lengths of stay were shorter in traditional group than in FTS group,and intraoperative and postoperative cerebrospinal fluid （CSF） leakage rate were significant lower in FTS group.There was no significant difference in tumor removal rate and diabetes insipidus （DI） between two groups.Conclusion FTS protocol is more profitable for the treatment of pituitary adenoma patients.

关 键 词：加速康复外科 垂体瘤 经鼻蝶手术 

分 类 号：R739[医药卫生—肿瘤]