眉弓入路显微手术治疗颅咽管瘤的临床应用及疗效

Clinical application and effect of microsurgery through eyebrow arch for the treatment of craniopharyngioma

目的分析眉弓入路显微手术治疗颅咽管瘤的临床效果及优势。方法选择2016年3月~2018年3月于本院接受眉弓锁孔入路显微手术治疗的颅咽管瘤患者20例为观察组,2015年1月~2016年2月于本院接受经冠状额下入路手术治疗的颅咽管瘤患者15例为对照组。比较两组的手术指标、肿瘤切除完整、症状改善以及并发症等情况。结果观察组手术时间、手术切口长度、住院时间均短于对照组,术野暴露程度满意度95.00%,高于对照组的66.67%(P<0.05),输血例数、治疗费用少于对照组。两组患者的颅咽管瘤全切除率比较,无统计学差异(P>0.05)。出院随访3个月,观察组的头痛、内分泌症状改善效果优于对照组(P<0.05),而嗅觉障碍、视力减退、多尿症状比较,无统计学差异(P>0.05)。观察组患者的并发症发生率为20.00%,低于对照组的66.67%(P<0.05)。结论经眉弓入路锁孔显微技术治疗颅咽管瘤,可获得良好的手术视野,脑组织损伤小,手术时间、住院时间较短,治疗费用、输血例数较少,头痛、内分泌症状明显改善,并发症发生率较低,值得推广。

Objective To analyze the clinical effect and advantages of microsurgery of eyebrow arch for the treatment of patients with craniopharyngioma.Methods From March 2016 to March 2018,20 patients with craniopharyngiomas who underwent microsurgical resection of eyebrow arch in our hospital were selected as the observation group;from January 2015 to February 2016,15 patients with craniopharyngiomas who were treated with traditional coronary intervention in our hospital were selected as the control group.Clinical indicators,the integrity of tumor resection,clinical improvement,and complications were analyzed in both groups.Results The operation time,hospitalization time and length of surgical incision in the observation group were shorter than those in the control group,and the cost of treatment and the numbers of blood transfusion were less than those of the control group,the satisfaction degree of the field exposure was 95.00%,which was statistically higher than the control group(66.67%),P<0.05.There was no statistical difference in the total resection rate of craniopharyngioma between the two groups.After 3 months of follow-up,the clinical manifestations of headache and endocrine symptoms in the observation group were better than those in the control group(P<0.05),while the olfactory disturbance,visual loss,and polyuria symptoms were not statistically different.The complication rate of the observation group was 20.00%,which was lower than that of the control group(66.67%),P<0.05.Conclusions The microscopic technique through the eyebrow arch can be used to minimally treat craniopharyngioma,which is worth promoting,because it can obtain a good surgical field of view,less damage to the brain tissue,shorter operation time and shorter hospital stay.The cost of treatment and the number of blood transfusions are also small.The headache and endocrine symptoms are significantly improved.The incidence of complications is low.