显微镜下单鼻孔扩大经蝶窦入路治疗巨大侵袭性垂体腺瘤的疗效分析  

Therapeutic effects of single nostril enlargement and transsphenoidal approach on giant invasive pituitary adenoma

作　　者：屈浙 田军[1] 胡昱红[1] 苏白玉 王坤[1] 檀浩鹏[1] 李建华[1] QU Zhe;TIAN Jun;HU Yuhong(Department of Neurosurgery,The First Hospital of Shijiazhuang City,Hebei,Shijiazhuang 050011,China)

机构地区：[1]河北省石家庄市第一医院神经外科

出　　处：《河北医药》2019年第23期3630-3633,共4页Hebei Medical Journal

基　　金：石家庄市科学技术研究与发展指导计划项目(编号:171461563)

摘　　要：目的探讨显微镜下单鼻孔扩大经蝶窦入路治疗巨大侵袭性垂体腺瘤的疗效。方法选取2009年6月至2014年6月收治的巨大侵袭性垂体瘤患者83例,根据随机数字表分为对照组(n=43)和显微组(n=40)。对照组采用传统开颅手术治疗,显微组采用微镜下单鼻孔扩大经蝶窦入路。观察2组手术情况(手术时间、术中出血量、术后住院时间)、肿瘤切除情况、日常生活能力分、并发症发生情况,患者随访至2018年7月,观察2组患者复发情况、生存时间、无瘤生存时间。结果显微组手术时间、术中出血量和术后住院时间均显著低于对照组,差异有统计学意义(P<0.05)。显微组肿瘤切除率高于对照组(P<0.05)。2组术后6个月的日常生活能力评分均显著高于术前,且显微组术后6个月高于对照组(P<0.05)。显微组并发症发生率显著低于对照组(P<0.05)。显微组生存时间、无瘤生存时间显著高于对照组(P<0.05)。显微组复发率低于对照组,但差异无统计学意义(P>0.05)。显微组复发2例,其中1例行γ刀治疗,另1例再次行显微镜下单鼻孔扩大经蝶窦入路手术治疗。结论显微镜下单鼻孔扩大经蝶窦入路治疗巨大侵袭性垂体腺瘤,手术暴露良好,全切率高、并发症发生率低,疗效确切。Objective To investigate the therapeutic effects of single nostril enlargement and transsphenoidal approach on giant invasive pituitary adenoma.Methods Eighty-three patients with giant invasive pituitary tumors were divided into control group(n=43)and microscopy group(n=40)according to the random number table.The patients control group were treated by traditional transsphenoidal surgery,however the patients in microscopy group were treated by microsurgical single nostril enlargement transsphenoidal approach.The operation status including operation time,intraoperative blood loss,postoperative hospital stay,and tumor resection status,daily living ability as well as the incidence of complications were observed.Moreover the patients in both groups were followed up until July 2018,and the recurrence rate,survival time and tumor-free survival time were observed and compared between the two groups.Results The operation time,intraoperative blood loss and postoperative hospital stay in microscopy group group were significantly lower than those in control group(P<0.05).The tumor resection rate in microscopy group was significantly higher than that in control group(P<0.05).The scores of daily living ability at 6m after operation in both groups were significantly higher than those before operation,moreover,which in in microscopy group group were significantly higher than those in control group(P<0.05).Moreover the incidence rate of complications in microscopy group was significantly lower than that in control group(P<0.05),and the survival time and tumor-free survival time in microscopy group were significantly higher than those in control group(P<0.05).The recurrence rate in microsurgery group was lower than that in control group,but there was no significant difference between the two groups(P>0.05).In addition there were 2 cases of recurrence in microscopy group group,in whom,1 case was treated byγ-knife,and the another one was treated by microsurgical single-nose enlargement transsphenoidal approach again.Conclusion Micr

关 键 词：巨大侵袭性垂体腺瘤 经蝶窦入路 显微镜外科手术 

分 类 号：R736.4[医药卫生—肿瘤]