神经内镜与显微镜下经鼻蝶垂体瘤切除术的临床应用比较

Comparison of Clinical Application of Endoscopic and Microsurgical Transsphenoidal Pituitary Adenoma Resection

目的:探究神经内镜与显微镜下经鼻蝶垂体瘤切除术的临床效果。方法:选择笔者所在医院2017年8月-2020年5月收治垂体瘤患者200例为研究对象,按数字奇偶法分为对照组100例与观察组100例,两组均行经鼻蝶入路垂体瘤切除术,对照组采用显微镜辅助,观察组采用神经内镜辅助。比较两组手术时间、术中出血量、住院时间,术后3个月复查CT、MRI,明确肿瘤切除与复发情况;比较术前、术后两组嗅觉功能,比较两组并发症发生情况。结果:观察组手术时间、术中出血量、住院时间短于对照组,差异有统计学意义(P<0.05);术后3个月复查结果显示,观察组肿瘤全切除率96.00%,高于对照组的85.00%,差异有统计学意义(P<0.05);术前两组嗅觉功能差异无统计学意义(P>0.05),术后观察组嗅觉功能优于对照组,差异有统计学意义(P<0.05);观察组术后并发症发生率3.00%,低于对照组17.00%,差异有统计学意义(P<0.05)。结论:与显微镜下经鼻蝶垂体瘤切除术比较,神经内镜下经鼻蝶垂体瘤切除术手术时间短、术中出血量少、住院时间短,更有利于嗅觉功能恢复,安全性高,值得应用与推广。

Objective:To explore the clinical effect of neuroendoscopy and microscopical transsphenoidal sphenoidal pituitary tumor resection.Method:A total of 200 patients with pituitary tumor admitted to our hospital from August 2017 to May 2020 were selected as study subjects.Accorded to the digital odd-even method,100 patients in the control group and 100 patients in the observation group were divided into the control group and the observation group.Both groups underwent transsphenoidal transsphenoidal pituitary tumor resection,while the control group was assisted by microscope and the observation group by neuroendoscopy.The operative time,intraoperative blood loss and length of hospital stay of the two groups were compared.CT and MRI were reviewed 3 months after surgery to confirm tumor resection and recurrence.The changes of olfactory function were compared between the two groups before and after operation,and the complications were compared between the two groups.Result:The operative time,intraoperative blood loss and hospital stay in the observation group were shorter than control group,and the differences were statistically significant(P<0.05).The results of reexamination 3 months after the operation showed that the total tumor resection rate of the observation group was 96.00%,higher than that of the control group(85.00%),with statistically significant difference(P<0.05).There was no statistically significant difference in olfactory function between the two groups before surgery(P>0.05).The olfactory function of the observation group after surgery was better than control group,and the differences were statistically significant(P<0.05).The incidence of postoperative complications in the observation group was 3.00%,which was lower than that of the control group(17.00%),with a statistically significant difference(P<0.05).Conclusion:Comparing with transsphenoidal sphenohypophysiectomy under the microscope,transsphenohypophysiectomy under the neuroendoscope has the advantages of shorting operative time,lessing intraoperative blood loss and shorting hospital stay,and is more conducive to the recoveriing of olour.It is safe and worthy of application and promotion.