摘要
目的观察神经导航引导下经单鼻孔蝶窦入路(经鼻蝶入路)垂体瘤切除术的应用效果,并总结围手术期的护理措施及要点。方法将2011年1月～2012年5月我院择期经鼻蝶入路行垂体瘤切除术患者110例分为对照组60例和观察组50例,对照组行常规经鼻蝶入路垂体瘤手术,观察组采用神经导航系统定位下垂体瘤切除术,观察两组手术时间、出血量、手术入路与瘤体偏差的距离和肿瘤全切率等。并实施相应的围手术期护理,包括术前鼻腔及导航使用前的各项准备,术后严密的病情观察、鼻腔护理、并发症的预防等有效措施。结果 110例患者均顺利完成手术,无死亡病例。观察组手术时间、出血量及手术入路与瘤体的偏差距离明显低于对照组,肿瘤全切率高于对照组,术后并发症发生率低于对照组,差异有统计学意义(P<0.05)。经积极治疗和精心护理后患者均痊愈出院。结论神经导航引导下经鼻蝶入路治疗垂体瘤定位准确、全切率高、出血量及并发症少,做好围手术期护理是保证垂体瘤切除术成功的关键。
Objective To assess the effect of neuronavigation-assisted pituitary adenoma resection via single nostril transsphenoidal approach, and to summarize the measures and key points in perioperative care. Methods We recruited 110 cases of patients, who were about to receive neuronavigation-assisted pituitary adenoma resection via nostril transsphenoidal approach in our hospital from January 2011 to May 2012. The patients were divided into two groups, the control group （60 cases） and the observation group （50 cases）. Patients in the control group underwent the conventional pituitary adenoma resection via nostril transsphenoidal approach, while those in the observation group underwent neuronavigation-assisted pituitary adenoma resection. We observed the time of operation, the amount of bleeding in patients, the distance between the adenoma and the site where we started the resection, and the complete removal rate for adenomas, and at the same time conducted relevant perioperative care which included preparations in nasal cavity and neuronavigation before operation. The patients were closely monitored, and nasal cavity care and precautions were taken to prevent complications after operation. Results The resection succeeded in 110 cases. No death occurred. The observation group got evidently better results than the control group did in the time of operation, the amount of bleeding, the accurate distance between the adenoma and the resection starting site, the complete removal rate for adenomas, and the incidence of complications. The differences were significant （P^0. 05）. After proactive treatment and careful nursing, all the patients were discharged from hospital after recovery. Conclusion The application of neuronavigation in pituitary adenoma resection via single nostril transsphenoidal approach is helpful in improving accuracy and the complete removal rate for adenomas, and in decreasing the amount of bleeding and complications. Perioperative care is the key to ensure the success of pituitary adenoma resection.
出处
《成都医学院学报》
CAS
2013年第4期495-497,共3页
Journal of Chengdu Medical College
关键词
神经导航
垂体瘤
鼻蝶入路
护理
Neuronavigation
Pituitary adenoma
Nostril transsphenoidal approach
Care
