硬性支撑联合带蒂鼻中隔黏膜瓣技术在垂体瘤术后鞍底重建中的应用

Application of rigid support combined with pedicled nasal septum mucosal flap technique in the reconstruction of sellar bottom after pituitary tumor surgery

目的探讨硬性支撑联合带蒂鼻中隔黏膜瓣技术在垂体瘤术后鞍底重建中的应用。方法采用回顾性和观察性的研究方法收集2019年8月至2023年5月西安交通大学第一附属医院神经外科完成的54例经鼻蝶垂体瘤切除患者的临床资料,依据鞍底重建方式分为硬性支撑组和软性重建组,比较两组手术时间、脑脊液漏发生及住院时间等情况。结果两组手术时间及术中出血量比较,差异无统计学意义(P>0.05)。硬性支撑组的术后脑脊液漏发生率及腰大池置管率低于软性重建组,住院时间短于软性重建组(P<0.05)。结论硬性支撑联合带蒂鼻中隔黏膜瓣技术能有效减少经鼻蝶垂体瘤术后脑脊液漏的发生。

Objective To explore the application of rigid support combined with predicled nasal septal mucosal flap technique in postoperative saddle-bottom reconstruction of pituitary tumor.Methods Using retrospective and observational research methods,the clinical data of 54 patients with transsphenoidal pituitary tumor resection completed by the Department of Neurosurgery of the First Affiliated Hospital of Xi'an Jiaotong University from August 2019 to May 2023 were collected and divided into rigid support group and soft reconstruction group based on the way of saddle-base reconstruction,and the length of surgery,the incidence of cerebrospinal fluid leakage,and the hospitalization time of both groups were compared and analyzed.Results The differences in operative time and peroperative bleeding between the two groups were not statistically significant(P>0.05).The incidence of postoperative cerebrospinal fluid leakage and the rate of lumbar large pool placement in the rigid support group were lower than that in soft reconstruction group,and the hospitalization time was shorter than that in soft reconstruction group(P<0.05).Conclusion Rigid support combined with predicled nasal septal mucosal flap technique can effectively reduce the incidence of cerebrospinal fluid leakage after transsphenoidal pituitary tumor surgery.