神经内镜与显微镜手术治疗垂体瘤疗效与安全性的Meta分析

Transnasal-Sphenoidal Neuroendoscopy and Microscopy in the Treatment of Pituitary Adenomas:A Meta Analysis

目的:评价神经内镜和显微镜手术治疗垂体瘤的疗效和安全性。方法:检索建库至2019年3月PubMed、EMBASE、CNKI等全文数据库,通过RevMan5.3软件进行Meta分析。结果:共纳入29项随机对照试验,Meta分析结果显示:经神经内镜手术较显微镜手术切除垂体瘤在术中出血量、术后住院时间、肿瘤全切率、激素水平恢复、术后脑脊液漏、尿崩、出血、颅内感染、鼻中隔穿孔和垂体功能低下等方面具有明显优势,且差异具有统计学意义。结论:神经内镜相比显微镜手术治疗垂体瘤更加利于患者术后恢复,缩短术后住院时间,且在减少术后并发症方面有明显优势。

Objective:To systematically evaluate the efficacy and safety of Transnasal-sphenoidal neuroendoscopy and microscopy in the treatment of pituitary adenomas.Methods:Following the principle of evidence-based medicine,the full text databases were collected from Pubmed,CNKI from database establishment to March 2019,data were analyzed by RevMan 5.3.Results:A total of 29 randomized controlled trials(RCTs)were included,Meta-analysis showed that neuroendoscopy had obvious advantages over microscopic in terms of intraoperative bleeding volume,post-operative hospital stay,total tumor resection rate,post-operative cerebrospinal fluid leakage,diabetes insipidus,hemorrhage,intracranial infection,perforation of nasal septum and hypopituitarism,differences are statistically significant.Conclusion:Compared with microscope surgery,neuroendoscopy is more conducive to the recovery of patients after surgery,shortens the postoperative hospital stay,and has obvious advantages in reducing postoperative complications.