神经内镜联合多模态神经导航系统切除无功能性垂体大腺瘤的临床应用

Clinical application of neuroendoscopy in resection of large nonfunctional pituitary adenomas under a multimodal neuronavigation system

目的探讨神经内镜联合多模态神经导航系统手术切除无功能性垂体大腺瘤的临床应用价值。方法回顾性分析76例采用神经内镜手术切除无功能性垂体大腺瘤患者的临床资料,其中,38例在多模态神经导航系统辅助下切除肿瘤(观察组),38例在无术中多模态神经系统导航辅助下对肿瘤进行切除(对照组)。对2组患者肿瘤的手术切除情况、术后并发症以及患者预后进行统计分析。结果观察组术中出血量及术后并发症少于对照组,2组差异有统计学意义(P<0.05)。2组患者的手术时间、垂体瘤全切率、术后住院时间、视野改善率和肿瘤复发率均无统计学差异(P>0.05)。结论神经内镜联合多模态神经导航系统,再辅以术中多普勒超声和电生理监测等手段为无功能性垂体大腺瘤的手术切除及患者预后提供了更完善的安全保障。

Objective To explore the clinical application of neuroendoscopy in the resection of large nonfunctional pituitary adenomas under a multimodal neuronavigation system.Methods The data of 76 patients who underwent surgical resection of nonfunctional pitu-itary adenomas under neuroendoscopy were retrospectively analyzed.Of these 76 patients,38 underwent surgical resection of pituitary adenomas under a multimodal neuronavigation system(observation group)and 38,without intraoperative multimodal navigation(control group).The operative conditions and postoperative prognosis of the observation and control groups were statistically analyzed and compared.Results The amount of intraoperative blood loss and postoperative complications in the observation group were less than those in the control group,and the differences between the two groups were statistically significant(P<0.05).There were no significant differences in operation time,pituitary tumor resection rate,postoperative hospital stay,visual field improvement rate,and tumor recurrence rate between both groups(P>0.05).Conclusion Under the multimodal neuronavigation system,combined reconstruction of three-dimensional images,intraoperative Doppler ultrasound,and electrophysiological monitoring provided a safe guarantee for reducing intraoperative bleeding and a smooth postoperative recovery in the resection of nonfunctional pituitary adenomas via neuroendoscopy.