内镜下经鼻蝶入路手术治疗鞍区病变疗效观察

Curative effect of endoscopic transsphenoidal approach in the sellar region lesions

目的观察和探讨内镜下经单鼻孔蝶窦入路手术治疗鞍区肿瘤的临床疗效,探寻治疗鞍区肿瘤的最佳手术方法,为临床治疗提供客观的理论依据。方法选取2012年1月-2014年1月该院就诊的择期手术的鞍区肿瘤患者46例作为研究观察对象,根据手术方法区别分为观察组22例,对照组24例。对照组给予开放性手术治疗,观察组则给予经单鼻孔蝶窦入路手术治疗,观察和分析两组患者临床症状改善情况和手术相关情况。结果针对头晕、闭经、阳痿、泌乳和视力恢复等临床症状改善情况进行观察和对比分析结果显示,应用内镜下经单鼻孔蝶窦入路手术治疗鞍区垂体肿瘤较传统开放性手术在头晕、闭经、阳痿、泌乳和视力恢复方面都有明显的优势,差异均具有统计学意义(P<0.05);应用内镜下经单鼻孔蝶窦入路手术治疗鞍区垂体肿瘤较传统开放性手术明显缩短了手术时间和住院时间,同时降低了术中出血量,差异均有统计学意义(P<0.05)。结论针对鞍区肿瘤患者给予经单鼻孔蝶窦入路手术治疗临床疗效显著,能有效改善临床表现,提高手术治疗的临床疗效性,值得临床推广应用。

[ Objective ] To observe the chnical effect of endoscopic transsphenoidal approach in the sellar region tumor, explore the best operation methods and provide the objective theory basis for its clinical treatment. [ Method ] 46 patients with sellar region tumor treated from January 2012 to January 2014 in our hospital were selected. The patients were divided into observation group （22 cases） and control group （24 cases） according to different operation methods. The control group adopted the open operation and observation group adopted the transspheuoidal approach. The improvements of clinical symptoms and operation conditions of two groups were analyzed. [ Result ] In terms of dizziness, amenorrhea, erectile dysfunction, lactation, vision recovery and other clinical symptoms, the endoscopic transsphenoidal approach had a better effect than open operation in the pituitary tumor （P 〈 0.05）; compared with open operation in the pituitary tumor, the endoscopic transsphenoidal approach had obviously shortened the opera- tion time and hospitalization time, reduced the intraoperative blood loss （P 〈 0.05）. [Conclusion] For patients with sellar region tumor, the transsphenoidal approach has an obvious clinical effect, can effectively improve the clinical situation and enhance the clinical efficacy. It is worthy of clinical promotion and application.