3D-Slicer软件联合神经导航在神经内镜下经鼻蝶窦入路垂体腺瘤切除术中的应用效果  

Application of 3D-Slicer software combined with neuronavigation in the resection of pituitary adenoma by transnasal sphenoidal approach under neuroendoscopy

作　　者：仇尔宁 池雅杰 范梅芳 许小兵 林发牧 卢乐年 陈达良 邱胜聪 马立毅 林继业 郑大海 Qiu Erning;Chi Yajie;Fan Meifang;Xu Xiaobing;Lin Famu;Lu Lenian;Chen Daliang;Qiu Shengcong;Ma Liyi;Lin Jiye;Zheng Dahai(Department of Neurosurgery,Shunde Hospital of Southern Medical University,The First People’s Hospital of Shunde,Foshan Guangdong 528300,China)

机构地区：[1]南方医科大学顺德医院(佛山市顺德区第一人民医院)神经外科,广东佛山528300

出　　处：《中国医刊》2025年第4期415-418,共4页Chinese Journal of Medicine

基　　金：“十四五”广东省临床重点专科建设项目;广东省佛山市自筹经费类科技创新项目(2220001005405);广东省佛山市“十四五”医学高水平重点专科项目(FSGSP145099)。

摘　　要：目的探讨3D-Slicer软件联合神经导航在神经内镜下经鼻蝶窦入路垂体腺瘤切除术中的应用效果。方法选取2019年1月至2024年2月南方医科大学顺德医院收治的76例垂体腺瘤患者为研究对象,采用随机数字表法分为对照组和观察组,每组38例。对照组给予传统神经内镜下经鼻蝶窦入路垂体腺瘤切除术。观察组给予3D-Slicer软件术前规划联合术中实时神经导航的神经内镜下经鼻蝶窦入路垂体腺瘤切除术。比较分析两组患者的手术相关指标、术后并发症发生情况以及手术前后的视觉功能[视野平均缺损(MD)、视野指数(VFI)、视野模式标准差(PSD)]。结果观察组患者的手术时间及术后住院时间均短于对照组,术中出血量低于对照组,差异均有统计学意义(P<0.05)。观察组患者的术后脑脊液漏发生率低于对照组,差异有统计学意义(P<0.05)。与术前比较,两组患者术后1个月的视野MD、视野PSD均降低,且观察组低于对照组,差异均有统计学意义(P<0.05);两组患者术后1个月的VFI均升高,且观察组高于对照组,差异均有统计学意义(P<0.05)。结论3D-Slicer软件术前规划联合术中神经导航有助于临床医师于术前制订精准手术计划,可缩短神经内镜下经鼻蝶窦入路垂体腺瘤切除术的手术时间,减少术中出血量和术后并发症的发生,且可改善患者的术后视觉功能。Objective To investigate the effect of 3D-Slicer software combined with neuronavigation in the resection of pituitary adenoma by transnasal sphenoidal approach under neuroendoscopy.Method 76 patients with pituitary adenoma admitted to Shunde Hospital of Southern Medical University from January 2019 to February 2024 were selected as the study objects,and they were divided into control group and observation group by random number table method,with 38 patients in each group.The control group was treated with traditional neuroendoscopy in the resection of pituitary adenoma by transnasal sphenoidal approach.The observation group was given 3D-Slicer software preoperative planning combined with intraoperative real-time neuronavigation in the resection of pituitary adenoma by transnasal sphenoidal approach under neuroendoscopy.Surgical indicators,postoperative complications,and visual function(visual MD,VFI,visual PSD)before and after surgery were compared between the two groups.Result The surgical time,intraoperative blood loss and postoperative hospital stay in the observation group were shorter or less than those in the control group,with statistical significance(P<0.05).The incidence of postoperative cerebrospinalfluid leakage in observation group was lower than that in control group,with statistical significance(P<0.05).Compared with before surgery,visual MD and PSD in two groups were decreased one month after surgery,and observation group was lower than control group,with statistical significance(P<0.05).Compared with before surgery,The VFI in two groups was increased one month after surgery,and the observation group was higher than the control group,with statistical significance(P<0.05).Conclusion 3D-Slicer software preoperative planning combined with intraoperative neuronavigation is conducive to the formulation of accurate surgical plan before surgery,which can shorten the surgical time in the resection of pituitary adenoma by transnasal sphenoidal approach under neuroendoscopy,and reduce intraoperative blood lo

关 键 词：3D-Slicer软件 神经导航 神经内镜 垂体腺瘤 

分 类 号：R651.1[医药卫生—外科学]