显微镜下经鼻蝶窦入路行垂体瘤切除术的疗效

The effect of resection of pituitary adenoma under a microscope nasal transsphenoidal

目的观察显微镜下经鼻蝶窦入路行垂体瘤切除术的临床疗效。方法选取32例垂体瘤患者,显微镜下经鼻蝶窦入路行肿瘤切除术。记录治疗有效率、并发症及相关激素水平的变化情况。结果全切率及治疗总有效率分别为81.25%、87.50%,皮质激素腺瘤、生长激素腺瘤及泌乳素腺瘤患者的治疗有效率分别为80.00%、90.91%、92.31%,均高于无功能腺瘤患者的66.67%(P<0.05)。并发症发生率为6.25%。经过治疗,泌乳素腺瘤患者的PRL显著降低,生长激素腺瘤患者的GH显著降低,与术前相比差异均有统计学意义(P<0.05)。结论显微镜下经鼻蝶窦入路行垂体瘤切除术可显著提高治疗有效率,降低并发症发生率,以及有效改善激素水平,值得临床推广应用。

Objective To analyze the effect of resection of pituitary adenoma under a microscopic nasal transsphenoidal approach. Methods Thirty-two patients with pituitary adenoma in hospital were selected and treated with resection of pituitary adenoma under a micro-scopic nasal transsphenoidal approach. Treatment effectiveness was recorded,and the complications and changes of related hormone level were analyzed as well. Results After treatment,the cutting rate and total effective rate was 81. 25%,87. 50%,respectively,and the treat-ment effectiveness in patients with cortical hormone adenomas,growth hormone adenoma and prolactin adenomas was 80. 00%,90. 91%, and 92. 31%,respectively,which was significantly higher than that in patients with non-functional adenomas (66. 67%)(χ2 =4. 2667, 6. 5641,4. 2667,P<0. 05). The total complication rate was 6. 25%. After treatment,PRL in adenomas patients was decreased significant-ly. GH in patients with growth hormone adenomas was decreased significantly,compared with the preoperative statistical difference (P<0. 05). Conclusion Resection of pituitary adenoma under a microscopic nasal transsphenoidal approach can significantly improve the treat-ment efficiency,reduce the incidence of complications,and effectively improve hormone levels. Since it belongs to the minimally invasive treatment,it should be worth clinical application.