神经导航辅助神经内镜经蝶手术治疗垂体瘤的疗效及安全性分析  

Curative Effect and Safety of Neuronavigation-assisted Ueuroendoscopic Transsphenoidal Surgery for Pituitary Adenoma

作　　者：陈立珂[1] 蓝美锐[1] 陈岷辉[1] CHEN Like;LAN Meirui;CHEN Minhui(The Fourth People's Hospital of Zigong,Zigong,643000)

机构地区：[1]四川省自贡市第四人民医院,643000

出　　处：《实用癌症杂志》2020年第6期936-939,共4页The Practical Journal of Cancer

摘　　要：目的分析神经导航辅助神经内镜经鼻蝶垂体瘤切除术的疗效及安全性。方法回顾性分析行手术治疗的84例垂体瘤患者临床资料,其中43例患者行神经导航辅助神经内镜经蝶垂体瘤切除术(神经内镜组),41例患者行显微镜下经蝶垂体瘤切除术(显微镜组);对两组手术一般情况、肿瘤切除程度、术后并发症、术后激素水平改善情况及术后6个月主要症状缓解情况进行统计分析。结果与显微镜组相比,神经内镜组手术时间较长,术中出血量较少,术后住院时间较短,肿瘤切除程度提高,术后并发症较少,均有统计学差异(P<0.05)。术后2周,神经内镜组血清HGH、PRL、ACTH水平均明显低于显微镜组(P<0.05)。术后6个月,神经内镜组月经失调、视力减退、复视、头痛的缓解率均高于显微镜组,但组间对比无统计学差异(P>0.05)。结论神经导航辅助神经内镜经蝶手术治疗垂体瘤具有较好疗效及安全性,优于显微镜手术。Objective To analyze the curative effect and safety of neuronavigation-assisted neuroendoscopic transsphenoidal surgery for pituitary adenoma.Methods The clinical data of 84 patients with pituitary adenomas treated by surgery were analyzed retrospectively.43 patients underwent neuronavigation-assisted neuroendoscopic transsphenoidal resection of pituitary adenoma(neuroendoscopic group)and 41 patients underwent microscopic transsphenoidal resection of pituitary adenoma(microscopic group).The general conditions of surgery,degree of tumor resection,postoperative complications,improvement of postoperative hormone levels and relief of main symptoms at 6 months after surgery were statistically analyzed.Results The surgical time of neuroendoscopic group was longer,the intraoperative blood loss was less,the length of postoperative hospital stay was shorter,the degree of tumor resection was greater,and postoperative complications were fewer than those in the microscopic group(P<0.05).Levels of serum HGH,PRL and ACTH in the neuroendoscopic group were significantly lower than those in the microscopic group at 2 weeks after surgery(P<0.05).The remission rates of menstrual disorders,vision loss,diplopia and headache in the neuroendoscopic group were higher than those in the microscopic group at 6 months after surgery(P>0.05).Conclusion The curative effect of neuronavigation-assisted neuroendoscopic transsphenoidal surgery for pituitary adenoma is better than that of microscopic surgery,with better safety.

关 键 词：垂体瘤 经鼻碟垂体瘤切除术 神经导航 内镜 

分 类 号：R730.264[医药卫生—肿瘤]