显微镜及神经内镜下经鼻蝶垂体瘤切除术术后嗅觉功能障碍对比分析  

Analysis of olfactory dysfunction after endoscopic and microscopic endonasal transsphenoidal surgery for pituitary adenoma

作　　者：霍显浩 王立婷[2] 梁云 侯乾[4] 田继辉[1] HUO Xianhao WANG Liting LIANG Yun HOUQian TIAN Jihui(Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan, 750001, China Department of Hepatobiliary Surgery, General Hospital of Ningxia Medical University EEG Room, Central Hospital of Guanxian County Department of Neurosurgery, People＇s Hospital of Xingtai)

机构地区：[1]宁夏医科大学总医院神经外科,银川750001 [2]宁夏医科大学总医院肝胆外科 [3]山东省冠县中心医院脑电图室 [4]邢台市人民医院神经外科

出　　处：《临床耳鼻咽喉头颈外科杂志》2017年第19期1512-1518,共7页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨显微镜下经鼻蝶窦入路(MTS)及神经内镜技术(ETS)下经鼻蝶入路术后出现嗅觉功能障碍的相关因素,以进一步指导临床诊治。方法:在回顾性研究中,对入组患者进行病例资料分析,并进行电话随访,记录术前术后嗅觉情况;利用五味试嗅液检测方法对前瞻性研究中的入组患者进行术前,术后1周、1个月、3个月、6个月检查,将结果进行统计学分析。结果:回顾性研究中,MTS组、ETS组患者术后嗅觉障碍发生率分别为67.74%和47.37%,差异无统计学意义(P>0.05),对可能的相关因素进行统计学分析,结果显示差异均无统计学意义。前瞻性研究中,ETS和MTS组术侧鼻腔、非术侧鼻腔的术前及术后结果之间、术后3次结果之间差异均有统计学意义(P<0.05);4次检查结果中,ETS组和MTS组患者各自术侧鼻腔与非术侧比较,差异无统计学意义(P>0.05)。结论:经鼻蝶手术入路切除垂体瘤术后会出现嗅觉功能障碍,积极做好术前鼻腔准备,术中尽可能保护鼻腔结构完整,术后给予适当处理,可能会降低嗅觉障碍发生率。Objective：To analyze the clinical data of patients with olfactory dysfunction after endoscopic or mi croscopic endonasal transsphenoidal approach, and to screen out the possible related factors, to guide clinical diag nosis and treatment, and to improve the patients＂ quality of life. Method： In the retrospective study, we analyze patients data, and follow up them with telephone, records the olfactory levels before and after surgery. In the prospective study, five odors were applied to test the olfactory function before the surgery, then one week, 3 weeks and 6 weeks after that. The results were statistically analyzed. Result： In the retrospective study, olfactory dysfunction occurred in 67.74%, 47.37% in MTS group and ETS group. The olfactory disorder had no significant difference （P〉0.05） among MTS group and ETS group after surgery. And the analysis of factors showed no significant difference. In the prospective study, there is significant difference between the preoperative results and postoperative results about the operative side and nonoperative side in ETS group and MTS group （P〈0.05）. In all results, there is no significant difference between operative side and nonoperative side in ETS group and MTS group （P〉0.05）. Conclusion：There is olfactory dysfunction after transsphenoidal surgery to resect pituitary adenomas. To prepare the nasal condition well preoperatively, protect the nasal structure intraoperatively and aplicate appropriate treatment postoperatively may reduce the incidence of olfactory disorder.

关 键 词：垂体腺瘤 经鼻蝶手术 嗅觉 神经内镜 显微镜 

分 类 号：R584[医药卫生—内分泌]