显微手术治疗侵袭型垂体腺瘤对于患者远期日常生活活动能力的影响

The long-term activities of daily living effects of microsurgery for the neural inner diameter patients

目的探讨显微手术治疗侵袭型垂体腺瘤对于患者远期日常生活活动能力的影响。方法 2012年4月到2015年2月选择在本院诊治的侵袭型垂体腺瘤患者78例,根据随机数字表法分为治疗组与对照组各39例,对照组给予传统经鼻蝶手术治疗,治疗组给予神经内镜下显微手术治疗。结果所有患者都手术顺利,治疗组与对照组的肿瘤全切除率分别为72.0%(28/39)和48.7%(19/39),组间对比差异有统计学意义(P<0.05)。治疗组术后脑脊液漏、颅内感染、垂体功能下降、鼻腔黏膜黏连、颅内出血等并发症发生情况明显少于对照组(P<0.05)。术后3个月治疗组与对照组的日常生活活动能力评分分别为82.93±4.14分和65.28±5.33分,都明显高于术前的50.66±4.29分和50.18±4.87分,同时组间对比(P<0.05)。随访到2015年8月,治疗组的平均生存时间与无瘤生存时间分别为24.98±4.13个月和21.76±3.19个月,而对照组分别为19.34±3.98个月和17.33±4.11个月,组间对比(P<0.05)。结论相对传统手术治疗,神经内镜下显微治疗侵袭性垂体腺瘤能提高肿瘤的全切率,具有更好的安全性,同时改善患者的远期日常生活活动能力,延长生存时间。

Objective To investigate the long-term activities of daily living of microsurgery for the neural inner diameter patients.Method From April 2012 to February 2015, selected 78 neural inner diameter patients in our hospital and were equally divided into the treatment group and the control group based on the random number table, the control group was given conventional transsphenoidal surgery, and the the treatment group was received endoscopic microsurgery. Results All patients underwent the operation were successfully, the cancer total removal rates in the treatment group and the control group were 72.0%（28/39） and 48.7%（19/39） respectively, compared to the differences between the two groups was statistically significant（P〈0.05）. The postoperative cerebrospinal fluid leakage, intracranial infections, pituitary dysfunction, nasal adhesions, intracranial bleeding complications in the treatment group were significantly less than the control group（P〈0.05）. The postoperative 3 months ADL scores in the treatment group and control group were 82.93±4.14 points and 65.28±5.33 points（P〈0.05） that were significantly higher than preoperative of 50.66±4.29 points and 50.18±4.87 points, compared differences between the two groups were significant（P〈0.05）. Followed-up to August 2015, the average survival time and tumor-free survival time in the treatment group were 24.98±4.13 months and 21.76±3.19 months, while the control group were 19.34±3.98 months and 17.33±4.11 months, compared differences between the two groups were significant（P〈0.05）. Conclusion Compared with the traditional surgery, endoscopic microsurgical treatment of invasive pituitary adenoma can be improved rate of total resection, it has better security, while improve the patient＇s long-term activities of daily living and prolong survival time.