不同微创手术方案经鼻蝶治疗垂体瘤的疗效观察

Observation on the therapeutic effect of different minimally invasive surgical methods for pituitary tumor

目的探讨不同微创手术方案经鼻蝶治疗垂体瘤的疗效。方法选取2012年1月至2014年9月间收治的160例垂体瘤患者,采用随机数表法分为观察组和对照组,各80例。观察组患者采用神经内镜下经鼻蝶治疗,对照组患者采用显微镜下经鼻蝶治疗。对比两组患者的全切率、手术时间、术中出血量、住院时间、术后并发症和术后一周各激素回落情况。结果两组患者全切率差异无统计学意义(P>0.05)。观察组患者术中出血量和住院时间均低于对照组患者,观察组患者手术时间长于对照组,差异有统计学意义(P<0.05)。观察组患者术后一周各项激素水平基本回落至正常范围或略微高于正常范围内,回落情况优于对照组患者,差异有统计学意义(P<0.05)。观察组和对照组患者术后并发症的总发生率分别为15.0%和60.0%,差异有统计学意义(P<0.05)。结论垂体瘤患者神经内镜下经鼻蝶治疗虽然手术时间略长,但对患者造成的创伤较小,术后并发症发生率较低,恢复较快,可以推广使用。

Objective To investigate the effect of treatment for pituitary tumor by intranasal treat- ment of different minimally invasive surgical procedures. Methods From January 2012 to September 2014, 160 patients with pituitary adenomas were enrolled in this study, 160 patients were randomly assigned into observation group and control group, each of 80 cases. Given observation group of patients endoscopic trans- sphenoidal treatment, the control group patients were given microscope transsphenoidal treatment. Compare the two groups of patients with total resection, operation time, blood loss, hospital stay, postoperative com- plications each hormone situation and ＇after a week down the situation. Results Full-cut difference between the two groups of patients was not statistically meaningful （P 〈 0.05）. Blood loss and length of stay of pa- tients in the observation group were lower than the control group of patients, the patients in the observation group than the control group leader of the operation time, the difference was statistically meaningful （ P 〈 O. 05 ）. A week after the observation group hormone levels basically down to a normal range or slightly above the normal range, lower than the control group of patients, the difference was statistically meaningful （ P 〈 O. 05 ）. Postoperative complications occurred in patients in the observation group was 15.0% of total postop- erative complications overall incidence of patients in the control group （60. 0% ）, the difference was statistically meaningful （P 〈 0. 05 ）. Conclusions Give patients with pituitary tumors endoscopic transsphenoidal surgery treatment although slightly Longer, but less trauma to the patient, the lower incidence of postoperative complications, faster recovery, can further promote and use in clinical practice.