神经内镜下经鼻蝶垂体瘤切除术治疗垂体瘤患者的效果  

Effects of neuroendoscopic transsphenoidal pituitary adenoma resection in treatment of pituitary adenoma patients

作　　者：刘晓峰 魏秀川 LIU Xiaofeng;WEI Xiuchuan(Department of Neurosurgery of Lanling County People’s Hospital,Linyi 277700 Shandong,China)

机构地区：[1]兰陵县人民医院神经外科,山东临沂277700

出　　处：《中国民康医学》2024年第8期11-14,18,共5页Medical Journal of Chinese People’s Health

摘　　要：目的:观察神经内镜下经鼻蝶垂体瘤切除术治疗垂体瘤患者的效果。方法:选取2018年2月至2023年2月该院收治的86例垂体瘤患者进行前瞻性研究,按随机数字表法将其分为对照组和观察组各43例。对照组行显微镜下经鼻蝶垂体瘤切除术治疗,观察组行神经内镜下经鼻蝶垂体瘤切除术治疗,比较两组手术相关指标(术中出血量、手术时间、住院时间),手术前后嗅觉、视觉功能恢复情况[视野平均缺损值(MD)、视野模式标准差(PSD)、视野指数(VFI)]、垂体相关激素指标[促肾上腺皮质激素(ACTH)、生长激素(GH)、泌乳素(PRL)、促甲状腺素(TSH)]水平、生命质量[健康调查简表(SF-36)]评分和术后1个月内并发症发生率。结果:观察组术中出血量少于对照组,手术时间和住院时间均短于对照组,差异有统计学意义(P<0.05);术后,观察组嗅觉阈评分低于对照组,MD和PSD均小于对照组,VFI高于对照组,差异有统计学意义(P<0.05);术后,观察组ACTH、GH、PRL、TSH水平均低于对照组,差异有统计学意义(P<0.05);术后,观察组生理机能、生理职能、躯体疼痛、一般健康状况、精力、社会功能、情感职能、精神健康等SF-36评分均高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为4.65%(2/43),低于对照组的18.60%(8/43),差异有统计学意义(P<0.05)。结论:神经内镜下经鼻蝶垂体瘤切除术治疗垂体瘤患者可提高生命质量,改善嗅觉、视觉功能恢复情况,降低手术相关指标、垂体相关激素指标水平和并发症发生率,效果优于显微镜下经鼻蝶垂体瘤切除术治疗。Objective:To observe effects of neuroendoscopic transsphenoidal pituitary adenoma resection in treatment of patients with pituitary adenoma.Methods:A prospective study was conducted on 86 patients with pituitary adenoma admitted to the hospital from February 2018 to February 2023.They were divided into control group and observation group according to the random number table method,43 cases in each.The control group was treated with transsphenoidal pituitary adenoma resection under microscope,while the observation group was treated with neuroendoscopic transsphenoidal pituitary adenoma resection.The levels of operation-related indexes(intraoperative blood loss,operation time,hospitalization time),the recovery of olfactory and visual function before and after the surgery[mean defect value(MD),pattern standard deviation(PSD),visual field index(VFI)],the pituitary hormone indexes[adrenocorticotropic hormone(ACTH),growth hormone(GH),prolactin(PRL),thyroid stimulating hormone(TSH)]levels,the quality of life[the MOS 36-item short form health survey(SF-36)]score before and after the surgery,and the incidence of complications within 1 month after the surgery were compared between the two groups.Results:The intraoperative blood loss in the observation group was less than that in the control group,the operation time and the hospitalization time were shorter than those in the control group,and the differences were statistically significant(P<0.05).After the surgery,the olfactory threshold score of the observation group was lower than that of the control group,the MD and PSD were lower than those of the control group,the VFI was higher than that of the control group,and the differences were statistically significant(P<0.05).After the surgery,the levels of ACTH,GH,PRL and TSH in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the surgery,the SF-36 scores of physiological function,physiological function,physical pain,general health status,vitality

关 键 词：垂体瘤 神经内镜 显微镜 经鼻蝶垂体瘤切除术 嗅觉功能 生命质量 视觉功能 

分 类 号：R739.41[医药卫生—肿瘤]