神经内镜与显微镜下经鼻蝶入路手术治疗复发性无功能性垂体腺瘤的有效性和安全性比较  

Efficacy and safety of neuroendoscopic and microscopic transsphenoidal surgery in the treatment of recurrent nonfunctional pituitary adenomas

作　　者：赵锦程[1] 王星[2] 吴磊[1] 韩莹[1] 李起超[1] ZHAO Jin-cheng;WANG Xing;WU Lei(Department of Neurosurgery,the First Hospital of Qinhuangdao City,Qinhuangdao Hebei 066000,China;Department of Endocrinology,the First Hospital of Qinhuangdao City,Qinhuangdao Hebei 066000,China)

机构地区：[1]秦皇岛市第一医院神经外二科,河北秦皇岛066000 [2]秦皇岛市第一医院内分泌二科,河北秦皇岛066000

出　　处：《临床和实验医学杂志》2021年第11期1185-1188,共4页Journal of Clinical and Experimental Medicine

基　　金：河北省医学适用技术跟踪项目(编号:GZ2020087)。

摘　　要：目的对比神经内镜与显微镜下经鼻蝶入路手术在复发性无功能性垂体腺瘤(PA)中的应用价值。方法前瞻性选取2016年1月至2020年1月于秦皇岛市第一医院神经外科接受治疗的50例复发性无功能性PA患者,按照双盲法分为观察组(n=25)与对照组(n=25)。均行经鼻蝶入路术治疗,观察组予以神经内镜,对照组则予以显微镜。比较2组患者的围术期指标(手术用时、术中出血量、住院时间)、有效性、安全性以及术后肿瘤复发情况。结果观察组患者手术用时、术中出血量为(152.73±32.18)min、(109.25±28.13)mL,高于对照组[(74.52±21.43)min、(61.53±19.08)mL],住院时间为(5.92±1.74)d,低于对照组[(7.61±1.25)d],差异均有统计学意义(P<0.05)。观察组患者治疗总有效率为84.00%,对照组治疗总有效率为76.00%;观察组并发症发生率为36.00%,对照组并发症发生率为28.00%;术后6个月随访,观察组肿瘤复发率为12.00%,对照组肿瘤复发率为16.00%。2组治疗总有效率、并发症发生率、肿瘤复发率比较,差异均无统计学意义(P>0.05)。结论复发性无功能性PA患者采用神经内镜与显微镜下经鼻蝶入路手术治疗均具有较高有效性与安全性,但神经内镜术患者住院时间较短,临床治疗时可依据患者具体病情选取最佳手术方式。Objective To compare the application value of endoscopic and microscopical transsphenoidal surgery in recurrent nonfunctional pituitary adenoma(PA).Methods Fifty patients with recurrent non-functional PA who received treatment in the Department of Neurosurgery in the First Hospital of Qinhuangdao City from January 2016 to January 2020 were prospectively selected and divided into observation group(n=25)and control group(n=25)according to the double-blind method.Both groups were treated by transsphenoidal approach.The observation group was treated by neuroendoscope,while the control group was treated by microscope.Perioperative indicators(operation time,intraoperative blood loss,length of hospital stay),efficacy,safety and postoperative tumor recurrence were compared between the two groups.Results The operation time and intraoperative blood loss of the observation group was(152.73±32.18)min and(109.25±28.13)mL,which was higher than that of the control group[(74.52±21.43)min,(61.53±19.08)mL],and the hospital stay was(5.92±1.74)d,which was lower than that of the control group[(7.61±1.25)d],the differences were statistically significant(P<0.05).The total effective rate of treatment in the observation group was 84.00%,and the total effective rate in the control group was 76.00%;the complication rate in the observation group was 36.00%,and the complication rate in the control group was 28.00%;follow-up 6 months after the operation,the tumor recurrence rate in the observation group was 12.00%,and the tumor recurrence rate in the control group was 16.00%.There was no statistically significant difference in the total effective rate,complication rate,and tumor recurrence rate between the two groups(P>0.05).Conclusion The treatment of recurrent nonfunctional pituitary adenoma by neuroendoscopy and transsphenoidal approach under microscope has high efficacy and safety,but the hospitalization time of patients with neuroendoscopy is short,so the best operation method can be selected according to the specific condition of

关 键 词：复发性无功能性垂体腺瘤 经鼻蝶入路 神经内镜 显微镜 

分 类 号：R736.4[医药卫生—肿瘤]