神经内镜辅助经单鼻孔蝶窦入路垂体腺瘤切除术的效果

Effect of Neuroendoscope-assisted Resection of Pituitary Adenoma Through Single Nostril and Sphenoid Sinus Approach

目的评价神经内镜辅助经单鼻孔蝶窦入路切除垂体腺瘤切临床效果。方法选取2017年1月~2019年12月在我院诊治的40例垂体腺瘤患者为研究对象,随机分为对照组和观察组,各20例。对照组在显微镜下经单鼻孔蝶窦入路做切除术,观察组在神经内镜辅助下经单鼻孔蝶窦入路行切除术,比较两组手术指标、肿瘤切除率、垂体激素水平、并发症发生率以及治疗满意度。结果观察组手术时间、术中出血量、住院时间均小于对照组,差异有统计学意义(P<0.05);观察组肿瘤切除率为95.00%,高于对照组的85.00%,差异有统计学意义(P<0.05);治疗后两组GH、PRL、ACTH水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为5.00%,低于对照组的15.00%,差异有统计学意义(P<0.05);观察组治疗满意度为100.00%,高于对照组的85.00%,差异有统计学意义(P<0.05)。结论单鼻孔蝶窦入路垂体腺瘤切除术经神经内镜进入可缩短手术时间、减少术中出血量、缩短住院时间,提高肿瘤切除率,降低垂体激素水平和并发症,值得临床应用。

Objective To evaluate the clinical effect of neuroendoscope-assisted resection of pituitary adenomas through a single nostril and sphenoid sinus approach.Methods A total of 40 patients with pituitary adenoma who were diagnosed and treated in our hospital from January 2017 to December 2019 were selected as the research objects,and they were randomly divided into a control group and an observation group,with 20 cases each.The control group underwent resection through a single nostril sphenoid sinus approach under a microscope,and the observation group underwent resection through a single nostril sphenoid sinus approach under the aid of neuroendoscope.The surgical indicators,tumor resection rate,pituitary hormone level,and complications were compared between the two groups.The incidence of symptoms and treatment satisfaction.Results The operation time,intraoperative blood loss,and hospital stay in the observation group were less than those in the control group,the difference was statistically significant(P<0.05);the tumor resection rate in the observation group was 95.00%,which was higher than 85.00%in the control group,the difference was statistically significant(P<0.05);After treatment,the levels of GH,PRL,and ACTH in the two groups were lower than before treatment,and the observation group was lower than the control group,the difference was statistically significant(P<0.05);the complication rate of the observation group was 5.00%,which was lower than that of the control group 15.00%,the difference was statistically significant(P<0.05);the treatment satisfaction of the observation group was 100.00%,which was higher than 85.00%of the control group,the difference was statistically significant(P<0.05).Conclusion Neuroendoscopic pituitary adenoma resection with single nostril and sphenoid sinus approach can shorten the operation time,reduce intraoperative blood loss,shorten hospital stay,increase tumor resection rate,and reduce pituitary hormone levels and complications.It is worthy of clinical application.