神经内镜辅助下经鼻蝶窦入路垂体瘤切除术的术中应激状况及疗效分析

Analysis of stress status and therapeutic effect of endoscopic resection of pituitary tumor via endoscope assisted resection of pituitary tumor

目的研究神经内镜辅助下经鼻蝶窦入路垂体瘤切除术的术中应激状况及疗效。方法选取2014年3月至2015年3月我院接诊的60例垂体瘤患者作为本次研究对象。观察组采取神经内镜辅助下经鼻蝶窦入路垂体瘤切除术进行治疗,对照组采取经口鼻下鼻中隔垂体瘤切除术进行治疗,观察两组患者术中应激反应情况、治疗相关指标、治疗后不良反应情况、治疗疗效情况。结果观察组肾上腺素(E)、去甲肾上腺素(NE)(98.30±12.11、103.42±15.03)ng/ml、肾素(R)、血管紧张素(ATⅡ)(2.33±0.52、28.12±5.51)pg/ml均小于对照组(160.15±19.08、188.72±20.58)ng/ml、(4.80±0.72、48.18±7.10)pg/ml差异具有统计学意义(P<0.05);观察组手术时间、术中出血量、术后住院时间均小于对照组,差异具有统计学意义(P<0.05);观察组不良反应总发生率10.00%(5/50)小于对照组44.00%(22/50),差异具有统计学意义(P<0.05);观察组激素下降程度、肿瘤残留、肿瘤体积减少程度均小于对照组,差异具有统计学意义(P<0.05)。结论神经内镜辅助下经鼻蝶窦入路垂体瘤切除术能够降低患者的术中应激水平,治疗疗效显著,能够有效的清除患者的肿瘤。

Objective To study the stress state and therapeutic effect of endoscopic pituitary tumor resection via endoscope assisted.Methods 60 cases of patients with pituitary adenoma from March 2014 to March 2015 in our hospital were researched.The patients in observation group were treated by endoscopic sinus surgery for pituitary tumor resection,The control group were treated by nasal septum pituitary tumor resection,Observe the two groups of patients with stress reaction,treatment related indicators,adverse reactions after treatment,treatment efficacy.Results Observation group adrenaline（E）,Norepinephrine（NE）（98.30±12.11、103.42±15.03）ng/ml、Renin（R）、Angiotensin（ATⅡ）（2.33±0.52、28.12±5.51）pg/ml Are less than the control group（160.15±19.08、188.72±20.58）ng/ml、（4.80±0.72、48.18±7.10）pg/ml The difference was statistically significant（P〈0.05）;The operation time,blood loss,postoperative hospital stay in the observation group were less than those in the control group,The difference was statistically significant（P〈0.05）;Incidence rate of adverse reactions in observation group10.00%（5/50）less than the control group44.00%（22/50）The difference was statistically significant（P〈0.05）;In the observation group,the level of hormone decline,tumor residual,tumor volume reduction were less than the control group,The difference was statistically significant（P〈0.05）.Conclusion Endoscopic assisted resection of pituitary tumor by endoscopic sinus surgery can reduce the level of stress in patients and has a significant curative effect.