经鼻蝶入路神经内镜与显微镜下垂体瘤切除术的疗效比较

Comparison of effects of transsphenoidal neuroendoscopy versus microscopic pituitary adenoma resection on pituitary adenoma

目的比较经鼻蝶入路神经内镜和显微镜下垂体瘤切除术治疗垂体瘤的效果。方法选取临汾市中心医院2016年5月至2019年5月收治的85例垂体瘤患者为研究对象,依照随机数字表法将其分为观察组(50例)及对照组(35例)。对照组行显微镜下垂体瘤切除术,观察组行经鼻蝶入路神经内镜垂体瘤切除术。观察两组的疗效、并发症发生率、治疗前后的激素水平及其视觉功能。结果观察组手术时间、术中出血量、住院时间及甲状腺激素、生长激素、促肾上腺皮质激素水平低于对照组,差异有统计学意义(P<0.05)。观察组患者缺损值为(3.18±0.87)dB,低于对照组的(6.87±1.35)dB,P<0.05。观察组模式标准差为(2.54±0.59)dB,低于对照组的(4.70±0.52)dB,P<0.05。观察组视野指数为(94.45±7.92)%,高于对照组的(82.36±7.70)%,P<0.05。观察组并发症发生率(4.00%,2/50)低于对照组(25.71%,9/35),χ^2=8.616,P<0.05。结论与显微镜下垂体瘤切除术相比,经鼻蝶入路神经内镜下垂体瘤切除术治疗垂体瘤具有更好的疗效,可降低术中出血量,恢复激素水平,改善视觉功能并有效降低并发症发生率。

Objective To compare the efficacy of transsphenoidal neuroendoscopy and microscopic pituitary resection on pituitary adenoma.Methods Eighty-five patients with pituitary adenomas treated in Linfen Central Hospital from May 2016 to May 2019 were selected and divided into observation group(n=50)and control group(n=35)by random number table method.The control group was treated by microscopic pituitary adenoma resection,and the observation group was treated by transsphenoidal neuroendoscopic pituitary adenoma resection.The curative effects,incidence of complications,hormone level and visual function before and after treatment of the two groups were observed.Results The operation time,intraoperative blood loss,hospital stay and levels of thyroid hormone,growth hormone and adrenocorticotropic hormone in the observation group were significantly lower than those in the control group(P<0.05).The mean deviation of visual field in the observation group was(3.18±0.87)dB,lower than the(6.87±1.35)dB in the control group(P<0.05).Pattern standard deviation in the observation group was(2.54±0.59)dB,lower than the(4.70±0.52)dB in the control group(P<0.05).The visual field index was(94.45±7.92)%in the observation group,higher than the(82.36±7.70)%in the control group(P<0.05).The incidence of complications in the observation group(4.00%,2/50)was lower than that in the control group(25.71%,9/35),χ^2=8.616,P<0.05.Conclusions Compared with microscopic pituitary adenoma resection,transsphenoidal neuroendoscopic pituitary adenoma resection has a better treatment effect,which can significantly reduce intraoperative bleeding,restore hormone levels,improve visual function,effectively reduce incidence of complications.