神经内镜和显微镜下垂体瘤切除术对患者术后激素水平及视觉恢复的影响  

Effects of Neuroendoscopic and Microscopical Pituitary Tumor Resection on Postoperative Hormone Levels and Visual Recovery

作　　者：潘东 殷陶冶[1] 张树恒[1] PAN Dong;YIN Taoye;ZHANG Shuheng(Department of Neurosurgery,Anshan Central Hospital,Anshan 114000,China)

机构地区：[1]辽宁省鞍山市中心医院神经外科,鞍山114000

出　　处：《宁夏医科大学学报》2021年第4期397-400,共4页Journal of Ningxia Medical University

摘　　要：目的分析神经内镜和显微镜垂体瘤切除术对患者术后激素水平和视觉恢复的影响。方法将辽宁省鞍山市中心医院2014年1月至2018年12月收治的60例垂体瘤患者作为研究对象,根据术式的不同,分为A组(26例)采取显微镜垂体瘤切除术,B组(34例)采取经鼻蝶神经内镜垂体瘤切除术。比较两组患者肿瘤切除率、手术前后激素水平和视觉恢复情况及术后并发症发生情况等。结果B组患者肿瘤全切率(94.12%)高于A组(65.38%)(P<0.05)。与术前比较,两组患者术后3 d生长激素、泌乳素及促肾上腺皮质激素(ACTH)水平均下降(P均<0.05);与A组比较,B组患者术后3 d生长激素、泌乳素及ACTH水平均下降(P均<0.05)。两组患者术后7 d患侧眼球模式标准差(PSD)和视野平均缺损(MD)均较术前下降,加权视野指数(VFI)较术前增高(P均<0.05);B组患者术后7 d时PSD和MD均较A组下降,VFI较A组增高(P均<0.05)。B组患者术后并发症总发生率(5.88%)低于A组(30.77%)(P<0.05)。结论经鼻蝶神经内镜垂体瘤切除术可有效提高垂体瘤患者肿瘤全切率,改善患者各项激素水平和视觉功能障碍,促进视觉恢复,降低术后并发症的发生率,具有较高的有效性和安全性。Objective To analyze the effects of neuroendoscopic and microscopic pituitary tumor resection on postoperative hormone levels and visual recovery of patients.Methods 60 patients with pituitary tumor admitted to our hospital from January 2014 to December 2018 were selected as the study subjects.According to the different surgical methods,they were divided into group A(26 cases)and group B(34 cases)with microscopical pituitary tumor resection and transsphenoidal neuroendoscopic pituitary tumor resection.Tumor resection rate,hormone levels before and after surgery,visual recovery and postoperative complications were compared between the two groups.Results The total tumor resection rate of group B was 94.12%,significantly higher than that of group A(65.38%)(P<0.05).Compared with the preoperative level,the levels of growth hormone,prolactin and adrenocorticotropin(ACTH)were significantly decreased 3 days after surgery in both groups(P all<0.05).Compared with group A,the levels of growth hormone,prolactin and ACTH were significantly decreased 3 days after surgery in group B(P all<0.05).The standard deviation(PSD)and mean visual field defect(MD)of the affected side of the eye were significantly decreased 7 days after surgery,and the weighted visual field index(VFI)was significantly increased(P all<0.05).At 7 d after surgery,PSD and MD in group B were significantly lower than those in group A,and VFI was significantly higher than that in group A(P all<0.05).The total incidence of postoperative complications in group B was 5.88%,significantly lower than 30.77%in group A(P<0.05).Conclusion Nasal butterfly neural endoscopic resection of pituitary adenoma can effectively increase the rate of tumor patients treated with cutting of pituitary adenoma,and also can effectively improve the hormone levels and visual function in patients with barriers,promote visual recovery,at the same time can effectively reduce the incidence of postoperative complications,has high efficacy and safety,therefore is worthy of clinical application.

关 键 词：垂体瘤 显微镜 神经内镜 激素 视觉 

分 类 号：R619[医药卫生—外科学]