神经内镜辅助显微镜切除颅咽管瘤的临床研究  

Clinical study of neuroendoscopy-assisted microscope resection of craniopharyngioma

作　　者：周帅 姜丽娜 王鲁飞 刘炜 郭嘉 王明鑫[1] 韩光良[1] Shuai Zhou;Lina Jiang;Lufei Wang;Wei Liu;Jia Guo;Mingxin Wang;Guangliang Han(Department of Head and Neck Vascular Surgery,Shengli Oilfield Central Hospital,Dongying 262700,China;Department of Neurology,Shengli Oilfield Central Hospital,Dongying 262700,China)

机构地区：[1]胜利油田中心医院头颈血管外科,山东东营262700 [2]胜利油田中心医院神经内科,山东东营262700

出　　处：《中华神经创伤外科电子杂志》2021年第5期288-292,共5页Chinese Journal Of Neurotraumatic Surgery：Electronic Edition

摘　　要：目的探讨神经内镜辅助显微镜技术在颅咽管瘤手术中的作用和价值。方法回顾性收集胜利油田中心医院神经外科和头颈血管外科自2015年1月至2017年11月收治的42例行神经内镜辅助显微镜切除的颅咽管瘤患者作为神经内镜辅助组,收集自2013年1月至2014年12月收治的45例行单纯经显微镜切除的颅咽管瘤患者作为单纯显微镜组,通过对2组患者的肿瘤切除率、术后并发症发生率及术后复发率进行比较,从而评价手术效果。结果神经内镜辅助组的肿瘤全切除率97.62%,术后血管痉挛发生率7.14%;单纯显微镜组的肿瘤全切除率80.00%,术后血管痉挛发生率22.22%,2组比较差异均具有统计学意义(P<0.05)。2组患者的术中垂体柄保留率、术后并发症(颅神经损伤、电解质紊乱、脑脊液漏、腺垂体功能减退、尿崩、颅内感染、死亡)发生率及术后复发率比较,差异均无统计学意义(P>0.05)。结论神经内镜辅助显微镜切除颅咽管瘤既能提高肿瘤全切除率又能降低并发症发生率,提高手术疗效。Objective To explore the role and value of neuroendoscopy-assisted microscope technique in craniopharyngioma surgery.Methods A total of 42 patients with craniopharyngioma underwent neuroendoscopic assisted microscopy resection admitted to Neurosurgery and Head and Neck vascularization Department of Shengli Oilfield Central Hospital from January 2015 to November 2017 were retrospectively collected.Forty-five patients with craniopharyngioma were resected underwent simple microscopic resection from January 2013 to December 2014 were collected.The resectable rate of craniopharyngioma,the incidence of postoperative complications and postoperative recurrence rate were compared to evaluate the effect of operation.Results In the neuroendoscopy-assisted microscope technique group,the total tumor resection rate was 97.62%,and the incidence of postoperative vasospasm was 7.14%;In the simple microscope group,the total tumor resection rate was 80.00%,and the incidence of postoperative vasospasm was 22.22%,there was significant statistical difference between the two groups(P<0.05).There was no significant difference in the retention rate of pituitary stalk during operation,the incidence of postoperative complications(cranial nerve injury,electrolyte disorder,cerebrospinal fluid leakage,adandular pituitary hypofunction,urinary collapse,intracranial infection and death)and postoperative recurrence rate between the two groups(P>0.05).Conclusion Neuroendoscope assisted microsurgery for craniopharyngioma can not only improve the total resection rate of tumor,but also reduce the incidence of complications,so as to better improve the surgical effect.

关 键 词：颅咽管瘤 神经内镜 显微镜 

分 类 号：R739.41[医药卫生—肿瘤]