神经内镜下经鼻中隔黏膜下入路与传统经鼻蝶入路垂体腺瘤切除术的疗效比较  

Comparison of the Therapeutic Effects of Endoscopic Transnasal Submucosal Approach and Traditional Transnasal Transsphenoidal Approach for Pituitary Adenoma Resection

作　　者：谭彬 陈翱 杨帆 向融 TAN Bin;CHEN Ao;YANG Fan(Department of Neurosurgery,Yueyang People's Hospital,Yueyang Hunan 414000)

机构地区：[1]岳阳市人民医院神经外科,湖南岳阳414000

出　　处：《医学临床研究》2024年第8期1144-1147,共4页Journal of Clinical Research

摘　　要：【目的】比较神经内镜下经鼻中隔黏膜下入路方式与传统经鼻蝶入路垂体腺瘤切除术的临床效果。【方法】回顾性分析2019年3月至2023年11月本院收治的85例垂体腺瘤患者的临床资料,根据手术入路方案不同将其分为鼻中隔黏膜下组(经鼻中隔黏膜下入路,n=45)和鼻蝶组(经鼻蝶入路,n=40)。比较两组术后并发症发生情况,手术前后嗅觉功能、鼻通气功能及激素水平。【结果】两组患者总有效率比较,差异无统计学意义(P>0.05)。鼻中隔黏膜下组的术中肿瘤切除率及脑脊液漏发生率与鼻蝶组比较,差异无统计学意义(P>0.05);鼻中隔黏膜下组的操作时间、出血量少于鼻蝶组,差异有统计学意义(P<0.05)。与术前比较,两组术后1个月、3个月、6个月嗅觉识别阈值高于术前,且鼻中隔黏膜下组低于鼻蝶组,差异有统计学意义(P<0.05)。术后3个月、6个月,两组鼻吸气阻力、呼气阻力高于术前,鼻中隔黏膜下组低于鼻蝶组,差异有统计学意义(P<0.05)。术后6个月,两组血清催乳素、生长激素、促肾上腺皮质激素水平低于术前(P<0.05),但两组术后6个月上述指标比较,差异无统计学意义(P>0.05)。鼻中隔黏膜下组术后并发症总发生率低于鼻蝶组,差异有统计学意义(P<0.05)。【结论】神经内镜下经鼻中隔黏膜下入路垂体腺瘤切除术对患者嗅觉功能损害较小,术后并发症发生率较低,具有较高的临床应用价值。【Objective】To compare the clinical outcomes of endoscopic transnasal submucosal approach and traditional transnasal transsphenoidal approach for pituitary adenoma resection.【Methods】A retrospective analysis was conducted on the clinical data of 85 patients with pituitary adenomas admitted to our hospital from March 2019 to April 2024.According to the surgical approach plan,they were divided into a nasal septum submucosal group(transnasal septum submucosal approach,n=45)and a nasal butterfly group(transnasal butterfly approach,n=40).The incidence of postoperative complications,olfactory function,nasal ventilation function,and hormone levels before and after surgery were compared between the two groups.【Results】There was no statistically significant difference in the total effective rate between the two groups of patients(P>0.05).The intraoperative tumor resection rate and cerebrospinal fluid leakage rate in the submucosal group of the nasal septum were not significantly different from those in the nasal butterfly group(P>0.05);The operation time and bleeding volume of the submucosal group of the nasal septum were lower than those of the nasal butterfly group,and the difference was statistically significant(P<0.05).Compared with preoperative values,the olfactory recognition thresholds of the two groups were higher at 1 month,3 months,and 6 months after surgery,and the nasal septum submucosal group was lower than the nasal butterfly group,with statistical significance(P<0.05).At 3 and 6 months after surgery,the nasal inspiratory and expiratory resistance in both groups were higher than before surgery,and the submucosal group of the nasal septum was lower than the nasal butterfly group,with a statistically significant difference(P<0.05).Six months after surgery,the levels of serum prolactin,growth hormone,and adrenocorticotropic hormone in both groups were lower than before surgery(P<0.05),but there was no significant difference in these indicators between the two groups at six months after surgery(P>0.05

关 键 词：垂体肿瘤/外科学 神经内窥镜检查 治疗结果 

分 类 号：R736.4[医药卫生—肿瘤]