摘要
目的对比分析神经内镜与显微镜下经鼻蝶垂体瘤切除术的安全性及疗效。方法回顾性分析2011年8月至2016年5月于郑州大学第一附属医院实施的经鼻蝶垂体瘤切除术的240例患者的临床资料,其中神经内镜下手术123例(内镜组),显微镜下手术117例(显微镜组),比较两组患者术中出血量、手术时间、术中脑脊液漏发生率、肿瘤全切率、术后症状缓解率、内分泌功能治愈率、术后并发症发生率、肿瘤复发率及住院时间,随访时间为3~61个月,定量资料组间比较采用t检验,定性资料组间比较采用χ~2检验。结果与显微镜组相比,内镜组术中出血量较少,术中脑脊液漏和术后并发症发生率较低,住院时间较短,差异均有统计学意义(P<0.05);内镜组手术时间长于显微镜组,差异有统计学意义(P<0.05);两组肿瘤全切率、术后症状缓解率、内分泌功能治愈率及肿瘤复发率比较,差异无统计学意义(P>0.05)。结论相对于显微镜,内镜下经鼻蝶垂体瘤手术是一种更为安全可靠的手术方式,能明显降低患者术后并发症发生率,缩短住院时间,值得临床推广。
Objective To compare the clinical efficacy and safety between endoscopic and microscopic surgery via transnasal - transsphenoidal approach for pituitary adenoma. Methods The clinical data of 240 patients with pituitary adenoma who under- went surgery via transnasal - transsphenoidal approach were analyzed retrospectively in the First Affiliated Hospital of Zhengzhou University from August of 2011 to May of 2016, including 123 cases of neural endoscopic surgery （ endoscopy group） and 117 ca- ses of microscopic surgery （microscope group）. The intraoperative blood loss, operative time, intraoperative cerebrospinal fluid leak rate, tumor total resection rate, postoperative symptom remission rate, cure rate of endocrine function, incidence rate of postoperative complications, tumor recurrence rate and length of hospital stay of two groups were compared. The follow - up time was 3 months to 61 months. The independent samples t - test was used for comparison of continuous data between two groups, and the chi - square test was used for comparison of categorical data between two groups. Results Compared with microscope group, endoscopic group had more less bleeding volume, lower rate in intraoperative cerebrospinal fluid leakage and postoperative complications, shorter length of hospital stay, and the differences were statistically significant （P 〈 0. 05 ）. Endoscopic operation time of endoscopic group was longer than the microscope group, and the difference was statistically significant （ P 〈 0. 05 ）. There was no statistically significant difference in tumor total resection rate, postoperative symptom remission rate, cure rate of endo- crine function and tumor recurrence rate between the two groups （ P 〉 0.05 ）. Conclusion Compared with microscope, endo- scopic endonasal transsphenoidal surgery is a more safe and reliable operation method, which can significantly reduce postoperative complications, shorten hospitalization time, worth clinical promotion.
作者
杨振宇
魏新亭
徐汝飞
Yang Zhenyu Wei Xinting Xu Rufei(Department of Neurosurgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Chin)
出处
《河南医学研究》
CAS
2017年第3期402-405,共4页
Henan Medical Research
关键词
垂体腺瘤
神经内镜
显微镜
经鼻蝶入路
疗效
pituitary adenomas
endoscopic surgery
mmicroscopic surgery
transnasal transsphenoidal approach
curative effect
