摘要
目的探究内镜下垂体瘤切除术治疗对垂体瘤患者激素、视功能的影响及其与预后的相关性。方法选取2021年1月至2024年1月南京医科大学附属淮安第一医院收治100例垂体瘤患者作为研究对象。全部病例均接受内镜下垂体瘤切除术治疗。记录患者手术指标、预后情况,以及手术前后的激素、视功能。根据患者术后格拉斯哥预后量表(GOS)评分分为预后良好组(GOS评分>3分)和预后不良组(GOS评分≤3分),对两组患者术后激素、视功能进行比较。通过Person法对激素、视功能与预后的相关性进行分析。结果手术时间30~126 min,平均(112.37±8.65)min;术中出血量42~84 mL,平均(60.39±6.42)mL;肿瘤切除率85%~97%,平均(93.51±1.47)%;住院时间3~8 d,平均(6.30±1.35)d。GOS评分2~5分,平均(4.21±0.76)分,92例患者预后良好,8例患者预后不良。患者术后催乳素(PRL)、促甲状腺素(TSH)、生长激素(GH)水平、视功能指数量表(VFI-14)评分、LogMAR BCVA及MD相较于术前均下降,而美国国立眼科研究院视功能问卷(NEIVFQ-25)评分增加(P<0.05)。预后良好组术后PRL、TSH、GH水平及VFI-14评分均低于预后不良组(P<0.05),NEI-VFQ-25评分高于预后不良组(P<0.05)。PRL、TSH、GH、VFI-14、BCVA、MD评分与GOS评分均呈负相关(r=-0.573、-0.219、-0.343、-0.386,P<0.05),而NEI-VFQ-25评分与GOS评分呈正相关(r=0.503,P<0.05)。结论内镜下垂体瘤切除术治疗垂体瘤患者具有手术操作时间短、创伤小、效果好、术后恢复快的特征,能够改善患者激素水平、视功能,且激素水平、视功能与患者预后有密切关系,BCVA和MD可作为客观预后评估指标。
Objective To explore the influence of endoscopic pituitary tumor resection on hormone and visual function in patients with pituitary tumor and their correlation with prognosis.Methods A total of 100 patients with pituitary tumor diagnosed and cured in our hospital from January 2021 to January 2024 were chosen as the study objects,all of whom received the endoscopic pituitary tumor resection.The surgical indicators and prognosis of patients were recorded,and the hormone and visual function before and after surgery were compared.The patients were divided into good(GOS scores>3 points)and poor prognosis group(GOS scores≤3 points)depending on the Glasgow outcome scale(GOS)scores after surgery,and the hormone and visual function after surgery of both groups were compared.The correlation between hormone,visual function and prognosis were analyzed by Spearman method.Results The surgical time was 30-126 min,with an average of(112.37±8.65)min.The intraoperative blood loss was 42-84 mL,with an average of(60.39±6.42)mL.The tumor resection rate was 85%-97%,with an average of(93.51±1.47)%.The hospitalization time was 3-8 days,with an average of 6.30±1.35 days.GOS scores were 2-5 points,with an average of(4.21±0.76)points,as 92 patients had good prognosis and 8 patients had poor prognosis.The prolactin(PRL),thyrotropin(TSH),growth hormone(GH)levels,visual function index scale(VFI-14)scores,LogMAR BCVA,and MD after surgery significantly decreased,while the national eye institute visual function questionnaire-25(NEI-VFQ-25)scores increased(P<0.05).The PRL,TSH,GH levels and VFI-14 scores of good prognosis group were significantly lower in comparison with the poor prognosis group(P<0.05),and the NEI-VFQ-25 scores were significantly higher in comparison with the poor prognosis group(P<0.05).PRL,TSH,GH,VFI-14 scores,BCVA,and MD were negatively correlated with GOS scores(r=-0.573,-0.219,-0.343,-0.386,P<0.05),while NEI-VFQ-25 scores were positively correlated with GOS scores(r=0.503,P<0.05).Conclusions Endoscopic pituitary tumor resection for patients with pituitary tumor has the characteristics of short surgical time,little trauma,good effect and quick postoperative recovery,which can improve the hormone and visual function,and the hormone,visual function are closely related to the prognosis of patients.BCVA and MD serve as objective prognostic indicators.
作者
陈秋实
刘智超
邓艳霞
刘家晖
丁涟沭
蒋健
CHEN Qiushi;LIU Zhichao;DENG Yanxia;LIU Jiahui;DING Lianshu;JIANG Jian(Department of Neurosurgery,Huai’an First Hospital Affiliated to Nanjing Medical University,Huai’an,Jiangsu 223300,China)
出处
《中华神经外科疾病研究杂志》
2025年第3期87-92,共6页
Chinese Journal of Neurosurgical Disease Research
基金
江苏省卫生健康委科研项目(ZD2021051)。
关键词
垂体瘤
内镜下垂体瘤切除术
激素
视功能
预后
Pituitary tumor
Endoscopic pituitary tumor resection
Hormone
Visual function
Prognosis
