磷酸钙人工骨在经鼻蝶入路垂体瘤切除术鞍底重建中的应用研究  

USE OF ARTIFICIAL BONE OF TRICALCIUM PHOPHATE IN SELLAR FLOOR REC ONSTRUCTION AFTER TR ANSSPHENOIDAL MICROSURGERY FOR PITUITARY ADEOMA

作　　者：崔鹏[1] 魏辉[2] 廉治刚[1] 董斌[1] 赵永顺[1] 

机构地区：[1]大连医科大学附属第一医院神经外科,辽宁大连116011 [2]大连市第三人民医院手外科

出　　处：《中国修复重建外科杂志》2015年第11期1405-1407,共3页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨经鼻蝶入路垂体瘤切除术中应用磷酸钙人工骨行鞍底重建的疗效。方法回顾分析2014年1月-12月接受经鼻蝶入路垂体瘤切除术治疗的85例垂体腺瘤患者临床资料,其中46例采用＂三明治＂方法行鞍底重建（对照组）,39例在＂三明治＂方法基础上联合磷酸钙人工骨（试验组）。两组患者性别、年龄、病程、肿瘤大小、侵袭性及鞍底破坏比较,差异均无统计学意义（P〉0.05）,具有可比性。结果对照组肿瘤全切除39例、次全切除7例,试验组分别为33例和6例;两组比较差异无统计学意义（Z=—1.303,P=0.193）。对照组术中发生脑脊液漏8例、术后2周内发生脑脊液漏4例,试验组仅术中发生脑脊液漏10例;两组术中脑脊液漏发生率比较,差异无统计学意义（Z=—1.748,P=0.080）,但试验组术后脑脊液漏发生率显著少于对照组（P=0.020）。试验组术后拔除纱条时间均为3 d,较对照组的（4.3±1.6）d显著缩短（t=2.236,P=0.033）。术后对照组35例获随访3-14个月,试验组33例获随访5-13个月。随访期间均无脑脊液漏发生。结论经鼻蝶入路垂体瘤切除术中,在＂三明治＂方法基础上联合应用磷酸钙人工骨行鞍底重建,可有效降低术后脑脊液漏发生率,缩短纱条拔除时间。Objective To explore the effectiveness of the usage of artificial bone of tricalcium phophate in sellar floor reconstruction after transsphenoidal microsurgery for pituitary adeoma. Methods Between January and December 2014, 85 patients with pituitary adema underwent transsphenoidal microsurgery, and the clinical data were retrospectively analyzed. ＂Sandiwich＂ was used for sellar floor reconstruction in 46 cases（control group）, and ＂sandiwich＂ combined with the artificial bone of tricalcium phophate in 39 cases（trial group）. There was no significant difference in gender, age, disease duration, size of tumor, invasiveness, and the degree of damage to the sellar floor between 2 groups（P〈0.05）. Results Total removal and subtotal removal of tumors were achieved in 39 cases and 7 cases of the control group, and in 33 cases and 6 cases of the trial group, showing no significant difference between 2 groups（Z= —1.303, P=0.193）. Cerebrospinal leakage occurred in 8 cases of the control group and in 10 cases of the trial group during operation, showing no significant difference（Z= —1.748, P=0.080）. The case number of cerebrospinal leakage in the control group（4 cases） was significantly more than that in the trial group（0） after operation（P=0.020）. The time of gauze removal in the trial group（3 days） was significant shorter than that in the control group [（4.3±1.6） days]（t=2.236, P=0.033）. The patients were followed up 3-14 months in the control group and 5-13 months in the trial group. No cerebrospinal leakage occurred during follow-up. Conclusion Sellar floor reconstruction with artificial bone of tricalcium phophate is safe, and it can reduce cerebrospinal leakage and shorten the time of gauze removal.

关 键 词：垂体腺瘤切除术 经鼻蝶手术 鞍底重建 脑脊液漏 

分 类 号：R736.4[医药卫生—肿瘤]