显微镜与神经内镜下经鼻蝶切除垂体瘤的效果对比

Comparison of the effect of transsphenoidal resection of pituitary tumor under microscope and neuroendoscope

目的:探讨显微镜与神经内镜下经鼻蝶切除垂体瘤的临床疗效。方法:选择2016年1月—2018年12月收治的垂体瘤患者122例,随机分为对照组(60例)和观察组(62例)。对照组采用显微镜下经鼻蝶入路切除术,观察组采用神经内镜下经鼻蝶入路切除术。比较两组垂体瘤切除效果、术后激素水平、术后视觉和嗅觉功能及术后并发症情况。结果:观察组垂体瘤全切率高于对照组(P<0.05);术后1周,两组间泌乳素(PRL)、生长激素(GH)、促肾上腺皮质激素(ACTH)水平比较,差异无统计学意义(P>0.05);观察组加权视野指数(VFI)、视野平均缺损(MD)、模式标准差(PSD)水平及嗅觉功能均优于对照组;观察组患者术后并发症发生率低于对照组(P<0.05)。结论:神经内镜下经鼻蝶切除肿瘤更完全,有利于术后视觉恢复,并对患者嗅觉功能影响更小,降低术后并发症的发生。

Objective:To compare the clinical efficacy of transsphenoidal resection of pituitary tumor under microscope and neuroendoscope.Methods:A total of 122 patients with pituitary tumors admitted from January 2016 to December 2018 were selected and randomly divided into a control group(60 cases) and an observation group(62 cases).The control group underwent transnasal sphenoid approach under the microscope,and the observation group underwent neuroendoscopic transnasal sphenoid approach.Pituitary tumor resection effects,postoperative hormone levels,postoperative visual and olfactory functions,and postoperative complications were compared between the two groups.Results:The pituitary tumor resection rate in the observation group was higher than that in the control group(P<0.05).At 1 week after surgery,there was no significant difference in the levels of prolactin(PRL),growth hormone(GH),and adrenocorticotropic hormone(ACTH) between the two groups(P>0.05).The weighted visual field index(VFI),mean visual field defect(MD),model standard deviation(PSD) level and olfactory function of the observation group were superior;the incidence of postoperative complications in the observation group was lower than that in the control group(P<0.05).Conclusion:compared with the traditional transsphenoidal approach for pituitary tumor resection,endoscopic resection of the tumor is more complete,and is more conducive to postoperative visual recovery,has less impact on the patients′ olfaction function,and reduces the incidence of postoperative complications.