文章摘要
余云湖,文远超,肖顺武.显微镜对比神经内镜下经单鼻孔蝶窦入路垂体瘤切除术临床疗效及安全性研究[J].中国医药导刊,2017,19(12):1264-1267.
显微镜对比神经内镜下经单鼻孔蝶窦入路垂体瘤切除术临床疗效及安全性研究
Contrast microscope by endoscopic endonasal transsphenoidal pituitary tumors, the clinical efficacy and safety of resection
投稿时间:2017-10-23  修订日期:2017-10-23
DOI:
中文关键词: 显微镜  神经内镜  经单鼻孔蝶窦入路  垂体瘤
英文关键词: Microscope  Endoscope  Single nostril transsphenoidal  Pituitary tumor
基金项目:遵义市科技局基金资助项目(项目编号:遵义市科合社字[2011]13号;项目名称:鼻中隔粘膜成形术在经鼻蝶入路手术中的研究与应用)
作者单位E-mail
余云湖 遵义医学院第三附属医院 davidlingli@163.com 
文远超 遵义医学院第三附属医院  
肖顺武 遵义医学院附属医院  
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中文摘要:
      目的:研究显微镜对比神经内镜下经单鼻孔蝶窦入路垂体瘤切除术的临床疗效及安全性。方法:选取2009年12月至2016年12月期间经手术治疗的垂体瘤患者162例,依据随机数字表法将患者分为两组:对照组81例行显微镜下单鼻孔蝶窦入路垂体瘤切除术和实验组81例行神经内镜下单鼻孔蝶窦入路垂体瘤切除术;观察两组患者术中出血量、肿瘤切除和手术并发症情况,分析患者术后症状恢复和体内激素恢复的状况。结果:对照组患者术中出血量、术后并发症发生率、术后住院时间及手术时间与实验组对比,差异有统计学意义(P<0.05);对照组患者激素水平恢复正常率及临床症状缓解率等围手术期及预后情况与实验组对比,差异有统计学意义(P<0.05);对照组患者感染3例,尿崩症7例,出血2例,垂体低功6例,脑脊液鼻漏10例及鼻中隔穿孔5例,实验组患者感染0例,尿崩症3例,出血0例,垂体低功0例,脑脊液鼻漏2例及鼻中隔穿孔1例,实验组治疗后并发症情况优于对照组,两组结果差异有统计学意义(P<0.05)。结论:神经内镜术更微创,切除肿瘤的过程更安全,患者具有较短的手术时间及住院时间,较低的病发率且术后反应更轻,神经内镜术较显微镜手术在激素改善及肿瘤全切率切除率方面具有明显优势。
英文摘要:
      Objective:To compare the clinical efficacy and safety of microscopic and endoscopic single nostril transsphenoidal approach pituitary adenoma resection. Methods: We selected 162 patients with pituitary tumors from December 2009 to December 2016 in our hospital for treatment, the patients were divided into two groups: the control group 81 cases were treated by microscopic single nostril transsphenoidal approach pituitary tumor resection, and experimental group of 81 cases underwent endoscopic single nostril transsphenoidal approach pituitary tumor resection; observation of two groups of patients with bleeding in the tumor resection, tumor excision and surgical complications, analysis of the symptoms of patients with postoperative recovery and hormone recovery situation. Results: The amount of bleeding during operation, postoperative complications, postoperative hospitalization time and operation time in the control group compared with the experimental group were different(P<0.05). Hormone level recovery rate and the clinical remission rate of perioperative period and the prognosis in the control group compared with the experimental group were different(P<0.05). In the control group, 3 cases of infection, 7 cases of diabetes insipidus, 2 cases of hemorrhage, 6 cases of pituitary low power, 10 cases of cerebrospinal fluid rhinorrhea and 5 cases of nasal septum perforation; in the experimental group, 0 case of infection, 3 cases of diabetes insipidus, 0 case of hemorrhage, 0 case of pituitary low power, 2 cases of cerebrospinal fluid rhinorrhea and 1 case of nasal septum perforation. Complication of experimental group was better than control group, the difference between the two groups was statistically significant (P<0.05). Conclusion: Endoscopic surgery is minimally invasive, process more secure, with shorter operation time and hospitalization time, lower the incidence of diseases and postoperative reaction is lighter. Neuroendoscopic surgery has obvious advantages in improving hormone level and the tumor resection and tumor excision rate.
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