神经内镜下经单侧鼻蝶窦入路垂体腺瘤切除术治疗垂体腺瘤疗效分析  

Analysis of the efficacy of neuroendoscopic unilateral endonasal transsphenoidal pituitary adenoma resection in the treatment of pituitary adenomas

作　　者：王明国 乔卿均[1] 饶克成[1] 廖磊[1] 高飞[1] Wang Mingguo;Qiao Qingjun;Rao Kecheng;Liao Lei;Gao Fei(Nanyang Second People's Hospital,Nanyang 473000,Henan,China)

机构地区：[1]南阳市第二人民医院,河南南阳473000

出　　处：《临床心身疾病杂志》2022年第1期139-141,共3页Journal of Clinical Psychosomatic Diseases

摘　　要：目的探讨神经内镜下经单侧鼻蝶窦入路垂体腺瘤切除术治疗垂体腺瘤的临床疗效。方法将73例垂体腺瘤患者按照随机数字表法分为研究组37例与对照组36例。对照组行显微镜下经单侧鼻蝶窦入路垂体腺瘤切除术,研究组行神经内镜下经单侧鼻蝶窦入路垂体腺瘤切除术,比较两组肿瘤切除效果、手术时间、术中失血量、住院时间、术前及术后3d血清去甲肾上腺激素、皮质醇水平,术后6个月比较两组复发率。结果研究组肿瘤切除效果显著好于对照组(P<0.05),手术时间及住院时间显著短于对照组(P<0.01),术中失血量显著少于对照组(P<0.01)。术后3d两组血清去甲肾上腺激素、皮质醇水平均较术前显著降低(P<0.01),研究组显著低于对照组(P<0.01)。术后6个月研究组复发率显著低于对照组(P<0.01)。结论神经内镜下经单侧鼻蝶窦入路垂体腺瘤切除术对垂体腺瘤患者肿瘤切除效果显著,能减少术中失血量,缩短手术时间、住院时间,减轻应激反应,降低复发率。Objective To explore the efficacy of neuroendoscopic unilateral endonasal transsphenoidal pituitary adenoma resection in the treatment of pituitary adenomas.Methods A total of 73 patients with pituitary adenomas were divided into study group(n=37) and control group(n=36) according to random number table method.The control group underwent unilateral endonasal transsphenoidal pituitary adenoma resection under the microscope,and the study group underwent neuroendoscopic unilateral endonasal transsphenoidal pituitary adenoma resection.The effect of tumor resection,operation time,intraoperative blood loss,length of hospital stays,serum norepinephrine(NE) and cortisol(Cor) levels before and 3 days after operation were compared between the two groups.The recurrence rate of the two groups was compared 6 months after operation.Results The effect of tumor resection in the study group was significantly better than that in the control group(P<0.05),the operation time and hospital stay were significantly shorter than those in the control group(P<0.01),and the intraoperative blood loss was significantly less than that in the control group(P<0.01).Three days after operation,the levels of serum NE and Cor in the two groups were significantly lower than those before operation(P < 0.01),the study group was significantly lower than the control group(P<0.01).The recurrence rate in the study group was significantly lower than that in the control group 6 months after operation(P<0.01).Conclusions Neuroendoscopic unilateral endonasal transsphenoidal pituitary adenoma resection has a significant effect on tumor resection in patients with pituitary adenoma,which can reduce intraoperative blood loss,shorten operation time and hospital stay,reduce stress response and reduce recurrence rate.

关 键 词：垂体腺瘤 神经内镜 显微镜 单侧鼻蝶窦入路 垂体腺瘤切除术 

分 类 号：R736.4[医药卫生—肿瘤]