神经内镜下经鼻-蝶窦入路手术治疗大型垂体腺瘤的学习曲线研究  

The learning curve of pituitary macroadenoma surgery through nerve endoscopic transsphenoidal

作　　者：郭孝龙[1] 周江朝[1] 程小兵[1] 

机构地区：[1]河南科技大学第一附属医院神经外科,洛阳471000

出　　处：《中国实用神经疾病杂志》2014年第12期7-10,共4页Chinese Journal of Practical Nervous Diseases

摘　　要：目的总结神经内镜经蝶大型垂体腺瘤手术的学习曲线。方法回顾性分析2009-01—2013-06由同一手术组连续完成的80例手术患者临床资料。按手术时间的先后分为4组(A^D),每组20例,分析不同阶段的手术效果。结果 4组年龄、性别、肿瘤大小和病理分类等方面比较差异无统计学意义(P>0.05);A、B、C、D 4组患者在手术时间依次递减,D组较前3组手术时间明显缩短,差异有统计学意义(P<0.05);且D组中转显微手术率较A^C组显著减少(P<0.05);术后并发症D组(0例)的发生率显著低于在A组(4例)、B组(4例)及C组(3例)(P<0.05)。结论神经内镜下经鼻蝶大型垂体腺瘤切除术的学习曲线在60例可达到较较熟练稳定的程度。Objective To investigate the learning curve of endoscopic transsphenoidal pituitary surgery .Methods From January 2009 to June 2013 ,80 patients undergoing endoscopic transsphenoidal pituitary surgery ,performed by a single team , were retrospectively evaluated .These patients were divided into 4 groups ,A to D group ,according to the succession of surgery , 20 cases in each stage ,the effectiveness of surgery was analyzed in different stages .Results No statistical differences were found among the group in age ,gender ,tumor size ,and pathological type （P〉0 .05）;the operative time were decreased in A group to D group in sequence ,and the operative time of D group was significantly shorter than those of the previous three groups（P〈0 .05）;the transit microsurgery rate of group D was significantly decreased compared with those of group A ,B and C （P〈0 .05）;the incidence of postoperative complications in group D （0 cases） was significantly lower than those in Group A （4 cases） ,group B （4 cases） and group C （3 cases） （P〈 0 .05） .Conclusion Endoscopic transsphenoidal pituitary surgery needs a minimum case-load of 60 patients to help go beyond the steep phase of the learning curve .

关 键 词：神经内镜 大型垂体腺瘤 经蝶入路 学习曲线 

分 类 号：R736.4[医药卫生—肿瘤]