神经内镜下单鼻孔经蝶窦入路手术治疗垂体腺瘤临床观察  

Clinical Observation of Neuroendoscopic Single-nostril Transsphenoidal Approach in Treatment of Patients with Pituitary Adenomas

作　　者：郑娜 许西海 ZHENG Na;XU Xi-hai(Department of Operating Room,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou,Hebei 061001,China;Department of Neurosurgery,the People's Hospital of Cangzhou,Cangzhou,Hebei 061001,China)

机构地区：[1]河北省沧州中西医结合医院手术室,河北沧州061001 [2]沧州市人民医院神经外科,河北沧州061001

出　　处：《临床误诊误治》2021年第10期59-62,67,共5页Clinical Misdiagnosis & Mistherapy

基　　金：河北省医学科学研究课题计划项目(20200293)。

摘　　要：目的分析神经内镜下单鼻孔经蝶窦入路手术治疗垂体腺瘤的临床效果。方法选取2015年2月—2018年3月收治的102例垂体腺瘤为研究对象,根据手术方法不同分为对照组49例和观察组53例。对照组给予传统经颅入路手术,观察组给予神经内镜下单鼻孔经蝶窦入路手术。比较两组围术期指标,手术前后生长激素(GH)、催乳素(PRL)、促肾上腺皮质激素(ACTH)水平及生活质量量表(QOL)评分。观察两组并发症发生情况,并随访6个月,记录术后复发率。结果观察组手术时间和住院时间短于对照组,术中出血量少于对照组(P<0.01)。术后,两组GH、PRL、ACTH水平均低于术前,且观察组低于对照组(P<0.05,P<0.01)。术后1个月,两组各部分QOL评分均高于术前,且观察组高于对照组(P<0.05,P<0.01)。观察组并发症总发生率及术后复发率均低于对照组(P<0.05)。结论神经内镜下单鼻孔经蝶窦入路手术治疗垂体腺瘤效果可靠,可提高患者生活质量,改善激素水平,降低术后复发率,是一种安全性高的术式。Objective To analyze clinical efficacy of neuroendoscopic single-nostril transsphenoidal approach in treatment of patients with pituitary adenomas.Methods A total of 102 patients with pituitary adenomas admitted between February 2015 and March 2018 were selected as research subjects,and the patients were divided into control group(n=49)and observation group(n=53)according to different surgical methods.Control group was given traditional transcranial surgery,while observation group was given neuroendoscopic single-nostril transsphenoidal surgery.The perioperative indicators,levels of growth hormone(GH),prolactin(PRL),adrenocorticotropic hormone(ACTH)and quality of life(QOL)scale scores before and after treatment were compared between two groups.Incidence rates of complications were observed,and recurrence rates after surgery were recorded after followed up for 6 months in two groups.Results Compared with those in control group,operative duration and length of hospital stay were significantly shorter,while intraoperative volume of blood loss was significantly less in observation group(P<0.01).After operation,levels of GH,PRL and ACTH were significantly lower than those before operation in two groups,and the levels in observation group were significantly lower than those in control group(P<0.05,P<0.01).After operation for 1 month,QOL scores of each part were significantly higher than those before operation in two groups,and the scores in observation group were significantly higher than those in control group(P<0.05,P<0.01).The total incidence rate of complications and postoperative recurrence rate in observation group were significantly lower than those in control group(P<0.05).Conclusion Neuroendoscopic single-nostril transsphenoidal surgery in treatment of patients with pituitary adenomas is effective,which may improve the quality of life,improve hormone levels and reduce postoperative recurrence of patients with good safety.

关 键 词：垂体腺瘤 神经内镜下单鼻孔经蝶窦入路 生长激素 催乳素 促肾上腺皮质激素 生活质量 

分 类 号：R736.4[医药卫生—肿瘤]