神经内镜和显微镜经鼻腔蝶窦入路治疗GH型垂体腺瘤患者的效果对比  

Comparison of the Effect of Neuroendoscope and Microscope Approach in the Treatment of Patients with GH-type Pituitary Adenoma through the Nasal Sphenoid Sinus

作　　者：孙炜[1] 李然 王俊文[1] 雷霆[1] SUN Wei;LI Ran;WANG Junwen;LEI Ting(Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;不详)

机构地区：[1]华中科技大学同济医学院附属同济医院,湖北武汉430030

出　　处：《中国医学创新》2022年第21期10-14,共5页Medical Innovation of China

基　　金：国家自然科学基金资助项目(82173136)。

摘　　要：目的:对比神经内镜和显微镜经鼻腔蝶窦入路治疗生长激素(GH)型垂体腺瘤患者的效果。方法:选取2019年1月-2021年11月华中科技大学同济医学院附属同济医院收治的63例GH型垂体腺瘤患者,按照随机数字表法将其分为对照组(n=31)和观察组(n=32)。对照组采用显微镜经鼻腔蝶窦入路,观察组采用神经内镜经鼻腔蝶窦入路。两组均随访3个月。比较两组手术情况、肿瘤切除程度、激素变化情况、视觉功能及并发症发生情况。结果:两组手术时间比较,差异无统计学意义(P>0.05)。观察组术中出血量少于对照组,差异有统计学意义(P<0.05)。观察组肿瘤切除程度优于对照组,差异有统计学意义(P<0.05)。随访结束后,两组GH、泌乳素(PRL)、促肾上腺皮质激素(ACTH)、视野平均缺损(MD)、模式标准差(PSD)、加权视野指数(VFI)比较,差异均无统计学意义(P>0.05)。两组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论:相较于显微镜经鼻腔蝶窦入路治疗GH型垂体腺瘤患者,神经内镜经鼻腔蝶窦入路更能有效切除肿瘤,控制术中出血量,且不影响手术时间、视觉功能、激素水平及并发症发生率。Objective:To compare the effect of neuroendoscopy and microscopy approach in the treatment of patients with growth hormone(GH)type pituitary adenoma through the nasal sphenoid sinus.Method:A total of 63 patients with GH type pituitary adenoma admitted to Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2019 to November 2021 were selected,they were divided into control group(n=31)and observation group(n=32)according to random number table method.The control group was treated with microscope approach through the nasal sphenoid sinus,and the observation group was treated with neuroendoscope approach through the nasal sphenoid sinus.Both groups were followed up for 3 months.Surgical index,tumor resection degree,hormone changes,visual function and complications were compared between the two groups.Result:There was no significant difference in surgical time between the two groups(P>0.05).The amount of intraoperative blood loss in the observation group was less than that in the control group,the difference was statistically significant(P<0.05).The degree of tumor resection in the observation group was better than that in the control group,the difference was statistically significant(P<0.05).After follow-up,there were no significant differences in GH,prolactin(PRL),adrenal corticotropic hormone(ACTH),mean visual field defect(MD),mode standard deviation(PSD)and weighted visual field index(VFI)between the two groups(P>0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion:Compared with the microscope approach through the nasal sphenoid sinus in the treatment of patients with GH-type pituitary adenomas,the neuroendoscope approach through the nasal sphenoid sinus is more effective in tumor resection,controls the amount of intraoperative blood loss,and does not affect the surgical time,visual function,hormone levels and complication rates.

关 键 词：神经内镜经鼻腔蝶窦入路 显微镜经鼻腔蝶窦入路 垂体腺瘤 

分 类 号：R736.4[医药卫生—肿瘤]