假包膜外切除技术在生长激素型垂体腺瘤神经内镜下经鼻蝶手术中的应用  

Application of Neuroendoscopic Transsphenoidal Pseudocapsular Resection in Growth Hormone Pituitary Adenomas

作　　者：郭爱顺 林镇荣 王毅喆 郑伟兴 GUO Aishun;LIN Zhenrong;WANG Yizhe;ZHENG Weixing(The Department of Neurosurgery,Zhangzhou Hospital Affiliated to Fujian Medical University,Zhangzhou Fujian 363000,China)

机构地区：[1]福建医科大学附属漳州市医院神经外科,福建漳州363000

出　　处：《河南医学高等专科学校学报》2022年第2期143-147,共5页Journal of Henan Medical College

基　　金：2019年福建省医学创新课题资助计划项目(2019-CX-46)。

摘　　要：目的探究假包膜外切除技术在生长激素(growth hormone,GH)型垂体腺瘤神经内镜下经鼻蝶手术中的应用价值。方法回顾性分析GH型垂体腺瘤神经内镜下经鼻蝶手术患者60例,按其治疗方式分为对照组和观察组,各30例。对照组行假包膜内切除术,观察组行假包膜外切除术。比较2组患者总肿瘤切除率、不同肿瘤大小及Knosp分级患者肿瘤切除率、并发症、对生活质量、GH水平及胰岛素样生长因子1(IGF-1)水平的影响。结果观察组患者总肿瘤全切除率90.00%,高于对照组的66.67%,且观察组大腺瘤患者全切除率高于对照组,2级、3级生长激素型垂体腺瘤患者肿瘤全切除率高于对照组,差异有统计学意义(P<0.05)。术后3个月观察组患者功能、总体健康状况指标评分高于对照组,症状、特异性指标分值低于对照组,GH、IGF-1水平低于对照组,差异有统计学意义(P<0.05)。2组患者并发症发生率差异无统计学意义(P>0.05)。结论假包膜外切除技术应用于GH型垂体腺瘤神经内镜下经鼻蝶手术中,对提升临床肿瘤切除率、改善患者生活质量及降低GH、IGF-1水平均有积极意义。Objective To explore the application of neuroendoscopic transsphenoidal pseudocapsular resection in growth hormone pituitary adenomas.Methods The clinical data of 60 patients with growth hormone pituitary adenoma who received neuroendoscopic transsphenoidal surgery were retrospectively analyzed.According to their treatment methods,all cases were divided into the control group and the observation group,30 cases in each group.The total tumor resection rate,and the effects of different tumor sizes and Knosp grades on tumor resection rate,complications,quality of life,growth hormone(GH)value and insulin-like growth factor 1(IGF-1)value,were compared between the two groups.Results The total tumor resection rate in the observation group was 90.00%,which was higher than 66.67%in the control group.The macroadenoma resection rate of the observation group was higher than that of the control group.And compared with the control group,the grade 2 and 3 growth hormone pituitary adenomas resection rate in the observation group was higher(P<0.05).At 3 months after operation,the scores of function and general health indicators in the observation group were higher than those in the control group,and the scores of symptoms and specific indicators were lower than those in the control group,and the values of GH and IGF-1 were lower than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion The application of neuroendoscopic transsphenoidal pseudocapsular resection in growth hormone pituitary adenomas has a positive effect on increasing tumor resection rate,improving patients’quality of life and reducing GH and IGF-1 values.

关 键 词：生长激素型垂体腺瘤 假包膜外切除技术 神经内镜下经鼻蝶手术 肿瘤切除率 生活质量 并发症 

分 类 号：R736.4[医药卫生—肿瘤]