期刊文献+

单鼻孔或双鼻孔经鼻蝶入路神经内镜手术治疗垂体瘤的效果分析 被引量:7

Analysis on effectiveness of single or double nostril transsphenoidal neuroendoscopic surgery for pituitary tumor
下载PDF
导出
摘要 目的探讨单鼻孔或双鼻孔经鼻蝶入路神经内镜手术治疗垂体瘤的效果。方法将我院行单鼻孔经鼻蝶入路神经内镜手术治疗的40例垂体瘤患者纳入单鼻孔组,将同期于我院行双鼻孔经鼻蝶入路神经内镜手术治疗的40例垂体瘤患者纳入双鼻孔组。比较2组患者肿瘤切除情况、术后临床症状改善情况、手术指标、并发症、泌乳素(PRL)水平、生长激素(GH)水平等。结果纳入本研究的80例患者术后均完成随访,随访时间12~19个月,平均(16.25±2.64)个月。术前2组视力视野受损均为40例,术后单鼻孔组视力视野明显改善或基本恢复正常者34例,双鼻孔组则为36例;术后2组患者头痛症状均明显缓解或消失。2组患者肿瘤总体切除率及垂体微腺瘤、1~2级垂体大腺瘤、3~4级垂体大腺瘤切除率比较,差异无统计学意义(P>0.05);单鼻孔组手术时间较双鼻孔组长,术中出血量较双鼻孔组多,差异有统计学意义(P<0.05);2组患者术后1 d、术后1个月血清PRL、GH水平均低于术前,术后1个月血清PRL、GH水平均低于术后1 d,差异有统计学意义(P<0.05);各时间点血清PRL、GH水平组间对比,差异无统计学意义(P>0.05);2组患者并发症发生率比较,差异无统计学意义(P>0.05)。结论单鼻孔及双鼻孔经鼻蝶入路神经内镜手术治疗垂体瘤均具有良好效果,可改善患者临床症状,与单鼻孔入路相比,双鼻孔入路不会增加术后并发症发生风险。临床对于瘤体较小的患者可选择单鼻孔入路手术,而巨大、侵袭性垂体瘤则适合选择双鼻孔入路手术。 Objective To investigate the effect of single or double nostril transsphenoidal neuroendoscopic surgery for pituitary tumor.Methods Forty patients with pituitary tumor who received single nostril transsphenoidal neuroendoscopic surgery in our hospital were included in the single nostril group,and 40 patients with pituitary tumor who received double nostril transsphenoidal neuroendoscopic surgery in our hospital during the same period were included in the double nostril group.Tumor resection,improvement of postoperative clinical symptoms,surgical indicators,complications,levels of prolactin(PRL)and growth hormone(GH)in the two groups were compared.Results All the 80 patients included in this study were followed up for 12 to 19 months,with an average of(16.25±2.64)months.There were 40 cases of visual field impairment in both groups before operation.After surgical treatment,the visual field of 34 patients in the single nostril group and 36 patients in the double nostril group were significantly improved or basically returned to normal;and the headache symptoms were significantly relieved or disappeared in both of the two groups.There was no significant difference in the overall tumor resection rate and the resection rate of pituitary microadenoma,grade 1 to 2 pituitary macroadenoma and grade 3 to 4 pituitary macroadenoma between the two groups(P>0.05).The operation time of the single nostril group was longer than that of the double nostril group,and the amount of intraoperative blood loss was more than that of the double nostril group,with statistically significant differences(P<0.05).In the two groups,the serum PRL and GH levels 1 day and 1 month after surgery were lower than those before surgery,and the serum PRL and GH levels 1 month after surgery were lower than those 1 day after surgery,the differences were statistically significant(P<0.05).There was no significant difference in serum PRL and GH levels at each time point between the two groups(P>0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Both single nostril and double nostril transsphenoidal neuroendoscopic surgery for pituitary tumor have good results,which can improve the clinical symptoms of patients.Compared with the single nostril approach,the double nostril approach does not increase the risk of postoperative complications.Single nostril approach is clinically suitable for patients with small tumor,while double nostril approach is suitable for patients with large and invasive pituitary tumor.
作者 邵云 浦毅 羊正祥 吴一平 缪伟锋 SHAO Yun;PU Yi;YANG Zheng-xiang;WU Yi-ping;MIAO Wei-feng(Department of Neurosurgery,Wuxi People’s Hospital,Wuxi Jiangsu 214000,China)
出处 《局解手术学杂志》 2022年第7期605-608,共4页 Journal of Regional Anatomy and Operative Surgery
基金 江苏省卫生健康委员会科研课题项目(19PJ063)。
关键词 垂体瘤 神经内镜 经鼻蝶入路 单鼻孔 双鼻孔 肿瘤切除率 pituitary tumor neuroendoscopy transsphenoidal approach single nostril double nostril tumor resection rate
  • 引文网络
  • 相关文献

参考文献12

二级参考文献59

共引文献142

同被引文献77

引证文献7

二级引证文献2

;
使用帮助 返回顶部