神经内镜辅助下经鼻蝶窦入路手术对垂体瘤PRL、HGH及ACTh水平的影响  

Effects of neuroendoscopy-assisted transsphenoidal approach on the levels of PRL,HGH and ACTh in pituitary tumors

作　　者：鲁彦 刘景云[1] 张人枭 LU Yan;LIU Jingyun;ZHANG Renxiao(Department of Neurosurgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan,China,450000)

机构地区：[1]郑州大学第一附属医院神经外科,河南郑州450000

出　　处：《分子诊断与治疗杂志》2022年第10期1684-1687,1691,共5页Journal of Molecular Diagnostics and Therapy

基　　金：河南省医学科技攻关计划项目(2019010026)。

摘　　要：目的 探讨神经内镜辅助下经鼻蝶窦入路手术治疗垂体瘤对泌乳素(PRL)、生长激素(HGH)、促肾上腺皮质激素(ACTH)水平的影响。方法 选取2019年12月至2021年12月郑州大学第一附属医院收治的128例垂体瘤患者,分为对照组(显微镜辅助下经鼻蝶窦入路)67例、观察组(神经内镜辅助下经鼻蝶窦入路)61例。比较两组手术指标、肿瘤全切率、PRL、HGH及ACTh水平、症状缓解率及手术不良反应。结果 观察组手术时间长于对照组,术后平均住院时间短于对照组,差异有统计学意义(P<0.05),两组术中出血量比较,差异无统计学意义(P>0.05)。观察组完全切除率85.25%,高于对照组的65.67%,差异有统计学意义(P<0.05)。术后,两组PRL、HGH及ACTh水平均下降,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组视力下降、头痛、性功能障碍缓解率均高于对照组,差异有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论 神经内镜辅助下经鼻蝶窦入路术治疗垂体瘤疗效确切,更有效地促进PRL、HGH及ACTh水平恢复到正常范围,且安全性较好,临床应用前景广阔。Objective To investigate the effect of neuroendoscope-assisted transnasal sphenoid surgery for pituitary tumors on the levels of prolactin(PRL),growth hormone(HGH)and corticotropin(ACTH).Methods 128 patients with pituitary tumors admitted to the First Affiliated Hospital of Zhengzhou University from December 2019 to December 2021 were selected and divided into the control group(transsphenoid sinus approach assisted by microscope)67 cases and the observation group(neuroendoscopy assisted transsphenoidal approach)61 cases. The surgical indicators,tumor total resection rate,PRL,HGH and ACTh levels,symptom relief rate and adverse surgical reactions were compared between the two groups. Results The operation time in the observation group was longer than that in the control group,and the average postoperative hospital stay was shorter than that in the control group,and the difference was statistically significant(P<0.05). There was no significant difference in the amount of intraoperative bleeding between the two groups(P>0.05). The complete resection rate of the observation group was 85.25%,which was higher than that of the control group,65.67%,and the difference was statistically significant(P<0.05). After operation,the levels of PRL,HGH and ACTh in the two groups decreased,and the observation group was lower than the control group,and the difference was statistically significant(P<0.05). The remission rate of vision loss,headache,and sexual dysfunction in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05). Conclusion Neuroendoscopy-assisted transsphenoidal approach in the treatment of pituitary tumors has a definite curative effect,and can more effectively promote the return of PRL,HGH and ACTh levels to the normal range,which has good safety and broad clinical application prospects.

关 键 词：神经内镜 经鼻蝶窦入路 垂体瘤 PRL HGH ACTH 

分 类 号：R736.4[医药卫生—肿瘤]