神经内镜经蝶窦入路手术治疗垂体瘤的临床效果  

Clinical effect of neuroendoscopic transsphenoidal approach surgery for pituitary tumors

作　　者：浦毅[1] 邵云[1] 缪伟锋[1] PU Yi;SHAO Yun;MIAO Wei-feng(Department of Neurosurgery,Wuxi People's Hospital,Wuxi Jiangsu 214023,China)

机构地区：[1]无锡市人民医院神经外科,江苏无锡214023

出　　处：《局解手术学杂志》2022年第1期31-35,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：江苏省卫生健康委员会2019年科研课题项目(19PJ063)。

摘　　要：目的探讨神经内镜经蝶窦入路手术治疗垂体瘤的临床效果。方法选取我院收治的垂体瘤患者60例,根据手术方案不同分为观察组(32例)和对照组(28例)。对照组采用神经显微镜经蝶窦入路手术治疗,观察组采用神经内镜经蝶窦入路手术治疗。比较2组手术效果、手术情况、并发症发生情况、手术前后血清PRL及GH水平、T细胞亚群(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))变化情况。结果观察组手术总有效率与对照组比较,差异无统计学意义(P>0.05);观察组术后住院时间短于对照组(P<0.05),术中失血量少于对照组(P<0.05),手术时间组间比较差异无统计学意义(P>0.05);术后1 d、术后1个月、术后3个月2组血清PRL、GH水平均逐渐降低(P<0.05),但组间比较差异无统计学意义(P>0.05);2组术后1 d的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均降低(P<0.05),术后1个月、术后3个月均升高(P<0.05),且观察组高于对照组(P<0.05);观察组并发症发生率与对照组比较,差异无统计学意义(P>0.05)。结论神经内镜经蝶窦入路手术治疗垂体瘤效果确切,能降低手术创伤,对机体免疫机能影响小,安全性高。Objective To investigate the clinical effect of neuroendoscopic transsphenoidal approach surgery for pituitary tumors.Methods A total of 60 patients with pituitary tumors in our hospital were selected and divided into the observation group(32 cases)and the control group(28 cases)according to the different surgical plans.The control group was treated with neuromicroscopic transsphenoidal approach surgery,and the observation group was treated with neuroendoscopic transsphenoidal approach surgery.The surgical effects,surgical conditions,incidence of complications,serum PRL and GH levels before and after operation,and the changes of T cell subsets(CD3^(+),CD4^(+),CD4^(+)/CD8^(+))were compared between the two groups.Results There was no statistically significant difference in the total effective rate of surgery between the observation group and the control group(P>0.05).The postoperative hospital stay of the observation group was shorter than that of the control group(P<0.05),the intraoperative blood loss was less than that of the control group(P<0.05),and there was no statistically significant difference in the operation time between the two groups(P>0.05).The serum PRL and GH levels in the two groups gradually decreased 1 day,1 month,and 3 months after operation(P>0.05),but the difference between the two groups was not statistically significant(P>0.05).The CD3^(+),CD4^(+),CD4^(+)/CD8^(+)of the two groups decreased 1 day after operation(P<0.05),and increased 1 month and 3 months after operation(P<0.05),and the CD3^(+),CD4^(+),CD4^(+)/CD8^(+)of the observation group were higher than those of the control group(P<0.05).There was no statistically significant difference in the incidence of complications between the observation group and the control group(P>0.05).Conclusion Neuroendoscopic transsphenoidal approach surgery for pituitary tumors is effective,which can reduce the surgical trauma,with little impact on the body immune function and high safety.

关 键 词：神经内镜 神经显微镜 经蝶窦入路 垂体瘤 泌乳素 生长激素 T细胞亚群 

分 类 号：R736.4[医药卫生—肿瘤]