医用胶原-羟基磷灰石人工骨用于鞍底重建的临床研究

Research of Medical Collagen-Hydroxyapatite Artificial Bone for Sellar Reconstruction

目的探索医用胶原-羟基磷灰石人工骨(CHA)用于鞍底重建的临床效果和应用前景。方法 2013年12月至2014年12月,共80例垂体瘤患者,随机分成两组,均在神经内镜下行经鼻碟鞍区病变切除术,试验组应用CHA修复鞍底,对照组按传统方法手术。术后随访3~6个月,比较两组患者术后一般情况、并发症情况,以及鞍底修复效果。结果两组患者手术时间、出血量及肿瘤全切率,均无显著差异(P>0.05);术后脑脊液漏发生率差异显著(P<0.05),其他术后并发症情况均无显著差异(P>0.05);术后6个月CT检查结果显示,试验组所有患者均可见新骨生成,CT值不同程度增加,并接近正常骨值,与对照组相比差异显著(P<0.05)。结论神经内镜经鼻手术创伤小,但仍不可避免出现脑脊液漏等并发症,应用CHA修复鞍底可显著减少该并发症的发生。

Objective To explore the effects and application prospect of the medical collagen-hydroxyapatite artificial bone （CHA） for sellar reconstruction. Methods From December 2013 to December 2014, 80 patients with pituitary adenoma were treated by endoscopic endonasal transsphenoidal surgery. All the patients were divided into two groups randomly. The patients of experimental group were used with CHA for sellar reconstruction, while the control group were treated by the traditional method. All the patients were followed up for 3-6 months. The general conditions, complications and sellar reconstruction of the 2 groups were observed and compared. Results There were no significant differences of operation time, blood loss and total resection rate between the 2 groups （P〉0.05）. Significant difference of the nasal cerebrospinal leaks was observed in the 2 groups （P〈0.05）, while no significant differences of other complications were observed （P〉0.05）. New bone formation was observed in experimental group according to the CT results, and the CT value increased to the normal. Compared with the control group, the difference was significant （P〈0.05）. Conclusion The endoscopic transsphenoidal surgery for pituitary tumors is widely applied with minimal invasiveness. But the cerebrospinal fluid leakage is still a common complication. Using CHA for sellar reconstruction can reduce the nasal cerebrospinal fluid leaks.