神经内镜与神经导航辅助显微镜下经鼻蝶入路切除垂体瘤的疗效比较

Neuroendoscopic and neuronavigation-assisted microscopy for the treatment of pituitary tumors via transsphenoidal approach

目的比较神经内镜与神经导航辅助显微镜下经鼻蝶入路切除垂体瘤的临床疗效。方法选取湖北医药学院附属襄阳市第一人民医院自2016年1月至2018年7月收治的160例垂体瘤患者,用硬币投掷法随机将患者分为神经内镜组(神经内镜下经鼻蝶入路切除垂体瘤)和神经导航组(神经导航辅助显微镜下经鼻蝶入路切除垂体瘤),每组80例。比较2组患者治疗前后催乳素(PRL)、生长激素(GH)、促肾上腺皮质激素(ACTH)含量,观察2组患者手术指标、临床疗效、并发症的发生情况。结果神经内镜组手术时间短于神经导航组患者,神经内镜组术中出血量少于神经导航组,神经内镜组术后住院时间短于神经导航组。治疗后比较,神经导航组患者PRL、GH、ACTH含量显著高于神经内镜组。神经内镜组患者有效率(92.50%)高于神经导航组(81.25%)。神经内镜组的尿崩症、视力障碍、鼻腔出血发生率均显著低于神经导航组(P<0.05)。结论神经内镜相较于神经导航辅助显微镜下经鼻蝶入路切除垂体瘤,临床疗效更佳,并发症少,患者垂体功能恢复情况更好。

Objective To compare the clinical efficacy of neuroendoscopy and neuronavigation assisted microscopy in the treatment of pituitary tumors by transnasal transsphenoidal approach.Methods One hundred and sixty patients with pituitary adenoma admitted to Xiangyang First People’s Hospital Affiliated to Hubei Medical College from January 2016 to July 2018 were selected.The patients were randomly divided into neural endoscopic group(neural endoscopic nasal adjustment approach resection of pituitary adenoma)and neural navigation group(neural navigation AIDS microscope nasal adjustment approach resection of pituitary adenoma),80 patients in each group.comparing two groups of patients before and after the treatment of growth hormone,prolactin(PRL),growth hormone(GH)and adrenocorticotropic hormone(ACTH)content difference,comparing two groups of patients with operation indicators,clinical curative effect and complications of statistical difference.Results The operation time in the neuroendoscopic group was shorter than that in the neuronavigation group,the intraoperative blood loss in the neuroendoscopic group was less than that in the neuronavigation group,and the postoperative hospitalization time in the neuroendoscopic group was shorter than that in the neuronavigation group.After treatment,PRL,GH and ACTH contents in patients in the neuronavigation group were significantly higher than those in the neuroendoscopy group.The effective rate of patients in the neuroendoscopic group(92.50%)was higher than that in the neuronavigation group(81.25%).The incidence of diabetes insipidus,visual impairment and nasal bleeding in the neuronavigation group was significantly higher than that in the neuroendoscopy group(P<0.05).Conclusion Compared with neuronavigation-assisted microscopy for the resection of pituitary tumor through nasal transsphenoidal approach,neuroendoscopy has better clinical efficacy,fewer complications and better recovery of pituitary function.