摘要
目的探讨垂体腺瘤患者采取经鼻蝶神经内镜下假包膜外分离切除术治疗的临床效果与安全性。方法选取2020年1月—2021年12月于南通大学第四附属医院接受神经内镜经鼻蝶垂体腺瘤切除术治疗的61例患者,根据切除方式不同分为观察组(31例)与对照组(30例),对照组采取包膜内切除术,观察组实施假包膜外分离切除术,统计两组患者全切率及功能性垂体腺瘤患者术后激素指标水平缓解率,记录对比两组患者临床手术指标(术中出血量、住院总时间),观察两组患者术后并发症情况。对患者进行为期6个月的跟踪随访,调查复发率。结果观察组垂体腺瘤患者全切率为90.32%,功能性垂体腺瘤术后激素水平缓解率为92.31%,均明显高于对照组,差异有统计学意义(χ^(2)=5.087、5.211,P<0.05)。观察组患者术中出血量低于对照组,住院总时间短于对照组,差异有统计学意义(P<0.05)。两组患者术中及术后脑脊液漏、颅内感染、垂体功能低下、暂时性尿崩的发生率比较,差异无统计学意义(P>0.05)。观察组垂体腺瘤患者术后复发率低于对照组,差异有统计学意义(P<0.05)。结论临床对垂体腺瘤患者进行神经内镜经鼻蝶垂体腺瘤切除术治疗可优选假包膜外分离切除方式,能够提高全切率和功能性垂体腺瘤的术后激素水平缓解率,不会增加垂体功能低下、暂时性尿崩、脑脊液漏、颅内感染等并发症的发生率,可降低术后复发率,安全性佳。
Objective To investigate the clinical effect and safety of patients with pituitary adenoma treated with transnasal sphenoidal endoscopic pseudocapsular separation.Methods 60 patients who underwent neuroendoscopic transsphenoidal pituitary adenoma resection in the Fourth Affiliated Hospital of Nantong University from January 2020 to December 2021 were selected,and the observation group(31 patients)and the control group(30 patients)were divided according to the different resection methods.The control group underwent intraperitoneal resection,and the observation group underwent pseudocapsular separation and excision.The total resection rate and the remission rate of hormonal indexes level in patients with functional pituitary adenoma were counted in two groups,and the clinical surgical indexes(intraoperative bleeding and total hospital stay)were recorded and compared in two group,and the postoperative complications were observed in two group.The patients were followed up for 6 months to investigate the recurrence rate.Results The complete resection rate of 90.32% in patients with pituitary adenoma and the postoperative hormonal level remission rate of 92.31% in patients with functional pituitary adenoma in the observation group were significantly higher than those in the control group,the differences was statistically significant(χ^(2)=5.087,5.211,P<0.05).Intraoperative bleeding was lower in the observation group than in the control group,and the total hospital stay was shorter than in the control group,the differences was statistically significant(P<0.05).There was no statistically significant difference in the incidence of intraoperative and postoperative cerebrospinal fluid leakage,intracranial infection,hypopituitarism,and transient uropathy between the two groups(P>0.05).The postoperative recurrence rate of pituitary adenoma patients in the observation group was lower than that in the control group,the differences was statistically significant(P<0.05).Conclusion In clinical treatment of pituitary adenoma patie
作者
江楠
郭俊
王朝翔
袁德彬
JIANG Nan;GUO Jun;WANG Chaoxiang;YUAN Debin(Department of Neurosurgery,the Fourth Affiliated Hospital of Nantong University(Yancheng First People's Hospital),Yancheng,Jiangsu Province,224001 China)
出处
《中外医疗》
2023年第4期81-85,共5页
China & Foreign Medical Treatment
关键词
假包膜外分离切除术
神经内镜
经鼻蝶垂体腺瘤切除术
效果
Pseudocapsular separation and excision
Neuroendoscopy
Transsphenoidal pituitary adenoma resection
Effect
