神经内镜经鼻蝶入路手术治疗功能性垂体瘤的效果及对应激反应的影响  

Effect of Neuroendoscopic Transnasal Transsphenoidal Approach in the Treatment of Functional Pituitary Adenomas and Its Effect on Stress Response

作　　者：刘乐 冷晓磊[1] 宋憧 魏伟 金点石[1] LIU Le;LENG Xiaolei;SONG Chong;WEI Wei;JIN Dianshi(Dalian Central Hospital,Liaoning Province,Dalian 116021,China;不详)

机构地区：[1]辽宁省大连市中心医院,辽宁大连116021

出　　处：《中国医学创新》2022年第1期41-45,共5页Medical Innovation of China

摘　　要：目的:探讨神经内镜经鼻蝶入路手术治疗功能性垂体瘤的效果及对应激反应的影响。方法:选择2016年1月-2021年1月大连市中心医院收治的功能性垂体瘤患者80例。根据治疗方式不同分为两组,接受神经内镜治疗的42例为A组,接受显微镜手术治疗的38例为B组。比较两组手术和住院情况,包括手术时间、术后住院时间及肿瘤全切除率;分别于术前及术后1 d检测两组血管紧张素Ⅱ(AngⅡ)、肾上腺素(E)及去甲肾上腺素(NE)水平以评价患者应激反应情况;比较两组不同垂体瘤类型激素改善率;术后随访6个月,比较两组并发症及复发情况。结果:A组手术时间及术后住院时间均短于B组(P<0.05),两组肿瘤全切率比较,差异无统计学意义(P>0.05)。两组术后1 d AngⅡ、E、NE均较术前升高,且A组均低于B组(P<0.05)。两组不同垂体瘤类型激素改善率比较,差异无统计学意义(P>0.05)。两组均无死亡及垂体功能低下发生,两组并发症发生率比较,差异无统计学意义(P>0.05)。A组随访期间无复发患者,B组1例(2.63%)复发,两组复发率比较,差异无统计学意义(P>0.05)。结论:与显微镜手术相比,神经内镜经鼻蝶入路手术治疗功能性垂体瘤手术时间及住院时间均较短,应激反应较轻,而在改善激素分泌及安全性方面相似。Objective:To investigate the efficacy of neuroendoscopic transnasal transsphenoidal approach in the treatment of functional pituitary adenomas and its effect on stress response.Method:A total of 80 patients with functional pituitary adenomas treated in Dalian Central Hospital from January 2016 to January 2021 were selected.According to different treatment methods,they were divided into two groups.42 cases treated with neuroendoscopy were group A and 38 cases treated with microscope were group B.Operation and hospitalization were compared between the two groups,including operation time,postoperative hospital stay and total resection rate of tumor.The levels of angiotensinⅡ(AngⅡ),epinephrine(E)and norepinephrine(NE)were detected before and 1 d after operation to evaluate the stress response of patients.The hormone improvement rates of different pituitary tumor types were compared between the two groups.The complications and recurrence were compared between the two groups after 6 months follow-up.Result:The operative time and postoperative hospital stay in group A were shorter than those in group B(P<0.05),and there was no significant difference in total tumor resection rate between the two groups(P>0.05).AngⅡ,E and NE in two groups were increased at 1 d after operation compared with those before operation,and group A were lower than those of group B(P<0.05).There were no significant differences in the hormone improvement rates of different pituitary tumor types between the two groups(P>0.05).There was no death or hypophysis in the two groups,and there was no significant difference in the incidence of complications between the two groups(P>0.05).There was no recurrence in group A and 1 case(2.63%)in group B during the follow-up period,there was no statistical significance in the recurrence rate between the two groups(P>0.05).Conclusion:Compared with microscopic surgery,neuroendoscopic transnasal transsphenoidal surgery for functional pituitary adenomas has shorter operation time and hospital stay,less stress r

关 键 词：神经内镜 经鼻蝶入路 功能性垂体瘤 应激反应 

分 类 号：R736.4[医药卫生—肿瘤]