经单鼻孔蝶窦入路垂体瘤切除术的并发症及相关因素分析

Analysis of post-operative complications and related factors of endonasal transsphenoidal ectomy of hypophyseoma

目的探讨经单鼻孔蝶窦入路垂体瘤切除术的并发症及相关发病因素。方法选择2006年7月至2014年3月间实施经单鼻孔蝶窦入路切除垂体瘤的178例垂体瘤患者,对其临床资料进行回顾性分析。结果 178例垂体瘤患者中,经单鼻孔蝶窦入路垂体瘤切除术治疗后,46例(25.8%)发生术后并发症,其中脑脊液漏8例(4.5%),鼻出血3例(1.7%),电解质紊乱4例(2.2%),尿崩症11例(6.2%),性功能低下13例(7.3%),视力减退3例(1.7%),颅内出血4例(2.2%)。单因素和多因素分析显示,术前内分泌紊乱、性欲降低、肿瘤≥3 cm与术后并发症的发生具有正相关性。结论术前积极纠正内分泌紊乱、综合评估肿瘤情况、提高术中操作技巧,能够降低术后并发症发生率。

Objective To explore the post-operative complications and related factors of endonasal transsphenoidal ectomy of hypophyseoma. Methods The clinical data of 178 patients with pituitary tumor treated by endonasal transsphenoidal ectomy of hypophyseoma in the Second Affiliated Hospital of Shenyang Medical College during the period from July 2006 to March 2014 were retrospectively analyzed. Results After the treatment of the endonasal transsphenoidal ectomy of hypophyseoma,46 patients occurred the post-operative complications（ 25. 8%） in the 178 patient with pituitary tumor including 8 cases of cerebrospinal fluid leakage（ 4. 5%）,3 cases of nasal hemorrhage（ 1. 7%）,4 cases of electrolyte disturbance（ 2. 2%）,11 cases of diabetes insipidus（ 6. 2%）,13 cases of low sexual function（ 7. 3%）,3 cases of decreased visual acuity（ 1. 7%）,4 cases of intracranial hemorrhage（ 2. 2%）. The preoperative endocrine disorder,low sexual function and tumor ≥ 3 cm were positive correlated with the incidence of post-operative complications by the signle factor and Logistic analysis. Conclusion The pre-operative correction of endocrine disorders,comprehension assessment of tumor,and the improvement of operation skills can effectively redue the incidence of post-operative complications.