摘要
目的总结神经内镜经蝶大型垂体腺瘤手术的学习曲线。方法回顾性分析2009-01—2013-06由同一手术组连续完成的80例手术患者临床资料。按手术时间的先后分为4组(A^D),每组20例,分析不同阶段的手术效果。结果 4组年龄、性别、肿瘤大小和病理分类等方面比较差异无统计学意义(P>0.05);A、B、C、D 4组患者在手术时间依次递减,D组较前3组手术时间明显缩短,差异有统计学意义(P<0.05);且D组中转显微手术率较A^C组显著减少(P<0.05);术后并发症D组(0例)的发生率显著低于在A组(4例)、B组(4例)及C组(3例)(P<0.05)。结论神经内镜下经鼻蝶大型垂体腺瘤切除术的学习曲线在60例可达到较较熟练稳定的程度。
Objective To investigate the learning curve of endoscopic transsphenoidal pituitary surgery .Methods From January 2009 to June 2013 ,80 patients undergoing endoscopic transsphenoidal pituitary surgery ,performed by a single team , were retrospectively evaluated .These patients were divided into 4 groups ,A to D group ,according to the succession of surgery , 20 cases in each stage ,the effectiveness of surgery was analyzed in different stages .Results No statistical differences were found among the group in age ,gender ,tumor size ,and pathological type （P〉0 .05）;the operative time were decreased in A group to D group in sequence ,and the operative time of D group was significantly shorter than those of the previous three groups（P〈0 .05）;the transit microsurgery rate of group D was significantly decreased compared with those of group A ,B and C （P〈0 .05）;the incidence of postoperative complications in group D （0 cases） was significantly lower than those in Group A （4 cases） ,group B （4 cases） and group C （3 cases） （P〈 0 .05） .Conclusion Endoscopic transsphenoidal pituitary surgery needs a minimum case-load of 60 patients to help go beyond the steep phase of the learning curve .
出处
《中国实用神经疾病杂志》
2014年第12期7-10,共4页
Chinese Journal of Practical Nervous Diseases
关键词
神经内镜
大型垂体腺瘤
经蝶入路
学习曲线
Endoscope
Pituitary macroadenoma
Endonasal transsphenoidal surgery
Learning curve
