3D打印技术用于经鼻蝶窦入路垂体腺瘤切除术应用效果及对血清MMP-9和IGF-1水平的影响

Application effect of 3D printing technique in pituitary adenoma resection of transnasal transsphenoidal approach and the effect of that on serum MMP-9 and IGF-1 levels

目的:探究3D打印技术在经鼻蝶窦入路垂体腺瘤(PA)切除术的应用效果及对血清基质金属蛋白酶-9(MMP-9)和胰岛素样生长因子-1(IGF-1)水平的影响。方法:选取2020年5月至2022年5月秦皇岛市第一医院收治的84例PA患者,按照随机数表法将其分为观察组和对照组,每组42例。对照组行经鼻蝶窦入路垂体腺瘤切除术,观察组行经鼻蝶窦入路垂体腺瘤切除术联合应用3D打印技术,比较两组肿瘤切除效果、围术期指标、视力改善情况、MMP-9和IGF-1水平,以及鼻腔功能的鼻气道阻力(NAR)、T&T嗅觉测试评分及并发症。结果:观察组肿瘤切除效果优于对照组,差异有统计学意义(U=2.286,P<0.05);观察组手术时间、术中出血量及住院时间均少于对照组,差异有统计学意义(t=4.780、11.438、11.842,P<0.05);术后3 d、7 d时观察组血清MMP-9和IGF-1水平低于对照组,差异有统计学意义(F=7.526、4.985,P<0.05);术后1个月、3个月时观察组NAR及T&T嗅觉测试评分低于对照组,差异有统计学意义(F=6.359、8.436,P<0.05);两组视力视野改善情况及并发症发生率比较,差异无统计学意义(P>0.05)。结论:3D打印技术用于经鼻蝶窦入路垂体腺瘤切除术可提高肿瘤切除效果,优化手术操作,减少创伤,有利于减轻疼痛,改善嗅觉功能与视力视野,并能降低血清MMP-9、IGF-1水平,且安全性较高。

Objective:To explore the application effect of 3-dimensional(3D)printing technique in pituitary adenoma(PA)resection of transnasal transsphenoidal approach and the effect of that on serum matrix metalloproteinase-9(MMP-9)and insulin-like growth factor-1(IGF-1)levels.Methods:A total of 84 PA patients admitted to First Hospital of Qinhuangdao from May 2020 to May 2022 were selected,and they were randomly divided into observation group and control group according to random number table,with 42 cases in each group.The control group underwent PA resection of transnasal transsphenoidal approach,and the observation group was combined with 3D printing technique on the basis of control group.The resection effect of tumor,perioperative indicators,visual improvement,serum MMP-9 and IGF-1,and nasal function[nasal airway resistance(NAR),T&T olfactory test score]and complications were compared between the two groups.Results:The effect of tumor resection in the observation group was significantly better than that in the control group(U=2.286,P<0.05),and the operation time,the amount of intraoperative blood loss and hospitalization time of the observation group were significantly less than those in the control group(t=4.780,11.438,11.842,P<0.05),respectively.The levels of serum MMP-9 and IGF-1 in the observation group were significantly lower than those in the control group at 3rd d and 7th d after operation(F=7.526,4.985,P<0.05),respectively.The NAR and T&T olfactory test scores in the observation group were significantly lower than those in the control group at the 1st month and 3rd months after operation(F=6.359,8.436,P<0.05),respectively.There were no significant differences in the improvements of visual acuity and visual field,and the incidence of complications between the two groups(P>0.05).Conclusion:3D printing technique that is used in PA resection of transnasal transsphenoidal approach can improve the effect of tumor resection,and optimize surgical operation,and reduce trauma,and help to relieve pain,and improve olfactory function and visual acuity and visual field,and reduce serum MMP-9 and IGF-1 levels,which has higher safety.