摘要
目的探析神经内镜辅助下经鼻蝶窦手术治疗垂体瘤的效果及价值。方法60例垂体瘤患者,依据手术方案不同分为对照组和观察组,每组30例。对照组予以显微镜辅助下经鼻蝶窦手术治疗,观察组采用神经内镜辅助下经鼻蝶窦手术治疗。比较两组患者症状缓解情况、并发症发生情况、视觉[视野模式标准差(PSD)、视野平均缺损(MD)、视野指数(VFI)]及嗅觉功能、神经内分泌激素[血清泌乳素(PRL)、生长激素(HGH)、促肾上腺皮质激素(ACTH)、促甲状腺激素(TSH)]水平。结果术后1个月,观察组视力下降缓解率70.00%、头痛缓解率83.33%、性功能障碍缓解率63.33%均较对照组的43.33%、56.67%、36.67%更高(P<0.05)。观察组并发症总发生率3.33%较对照组的20.00%更低(P<0.05)。术后,观察组PSD(4.77±0.59)dB、MD(4.50±0.79)dB、嗅觉识别阈值(3.01±0.32)较对照组的(6.15±0.73)、(5.72±0.86)dB、(3.75±0.36)更低,VFI(88.63±6.62)%较对照组的(80.85±6.04)%更高(P<0.05)。术后,观察组PRL(22.01±3.88)ng/ml、TSH(0.78±0.14)mIU/L、HGH(7.20±1.67)ng/ml、ACTH(14.31±2.40)pmol/L较对照组的(31.57±4.80)ng/ml、(1.05±0.23)mIU/L、(11.11±2.03)ng/ml、(20.03±2.44)pmol/L更低(P<0.05)。结论采用神经内镜辅助下经鼻蝶窦手术治疗垂体瘤相对于显微镜辅助手术具有多个方面的优势,包括更清晰的手术视野、更高的微创性和精准性、更短的术后症状缓解时间以及对嗅觉功能的保护、术后并发症预防处理和对内分泌激素水平的更有效调节等,使得神经内镜手术成为治疗垂体瘤的一种重要手段,为患者带来更好的治疗效果。
Objective To explore the effect and value of neuroendoscopic-assisted transnasal transsphenoidal surgery for pituitary tumors.Methods 60 patients with pituitary tumors were divided into a control group and an observation group according to different surgical plans,each consisting of 30 patients.The control group received microscopy-assisted transnasal transsphenoidal surgery,while the observation group received neuroendoscopic-assisted transnasal transsphenoidal surgery.Patients in both groups were compared in terms of symptom relief,occurrence of complications,visual function[pattern standard deviation(PSD),mean deviation(MD),visual field index(VFI)],olfactory function,neuroendocrine hormone[serum prolactin(PRL),human growth hormone(HGH),adrenocorticotropic hormone(ACTH),thyroid stimulating hormone(TSH)]levels.Results 1 month after surgery,the remission rates of decreased vision,headache and sexual dysfunction in the observation group were 70.00%,83.33%and 63.33%,which were higher than 43.33%,56.67%and 36.67%in the control group(P<0.05).The total complication rate of 3.33%in the observation group was lower than 20.00%in the control group(P<0.05).After surgery,the observation group had PSD of(4.77±0.59)dB,MD of(4.50±0.79)dB,and olfactory recognition threshold of(3.01±0.32),which were lower than(6.15±0.73),(5.72±0.86)dB,and(3.75±0.36)in the control group;the observation group had a higher VFI of(88.63±6.62)%than(80.85±6.04)%in the control group(P<0.05).After surgery,the observation group had PRL of(22.01±3.88)ng/ml,TSH of(0.78±0.14)mIU/L,HGH of(7.20±1.67)ng/ml,and ACTH of(14.31±2.40)pmol/L,which were lower than(31.57±4.80)ng/ml,(1.05±0.23)mIU/L,(11.11±2.03)ng/ml,and(20.03±2.44)pmol/L in the control group(P<0.05).Conclusion Neuroendoscopic-assisted transnasal transsphenoidal surgery for pituitary tumor has several advantages over microscopy-assisted surgery,including clearer surgical field,higher minimally invasiveness and precision,shorter postoperative symptomatic relief time,as well as protection of olfactory function,prevention and treatment of postoperative complications,and more effective regulation of endocrine hormone levels,which makes neuroendoscopic surgery an important treatment tool for pituitary tumor.Therefore,neuroendoscopic surgery becomes an important means for the treatment of pituitary tumors and brings better therapeutic effects to patients.
作者
李谋仪
黄锦聪
林志忠
江志贤
张晋宁
LI Mou-yi;HUANG Jin-cong;LIN Zhi-zhong(Department of Neurosurgery,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou 362000,China)
出处
《中国现代药物应用》
2025年第10期39-42,共4页
Chinese Journal of Modern Drug Application
关键词
垂体瘤
神经内镜
经鼻蝶窦手术
并发症
视觉功能
嗅觉功能
神经内分泌激素
Pituitary tumors
Neuroendoscopy
Transnasal transsphenoidal surgery
Complication
Visual function
Olfactory function
Neuroendocrine hormones
