【摘要】 目的:探讨神经内镜与显微镜下经鼻蝶垂体腺瘤切除术的手术效果。方法:回顾分析2009年12月至2012年12月收治的263例患者的临床资料,其中105例行神经内镜垂体腺瘤切除术(内镜组),158例行显微镜下经鼻蝶入路垂体腺瘤切除术(显微镜组),对比分析两组患者手术时间、出血量、手术切除率、术后并发症发生率、术后住院时间等指标。结果:内镜组手术时间较显微镜组长[(78.7±34.55)min vs.(66.8±31.32)min](P=0.014);两组术中出血量差异无统计学意义[(60.6±32.35)ml vs.(55.1±24.63)ml](P=0.943);两组手术全切率差异亦无统计学意义(93.3%vs.92.4%)(P=0.7760);内镜组术后并发症发生率低于显微镜组(5.71%vs.13.29%),差异有统计学意义(P=0.0470)。内镜组术后住院时间较显微镜组短[(6.12±1.94)d vs.(7.13±1.57)d],差异有统计学意义(P=0.0166)。结论:神经内镜手术在肿瘤全切方面与显微镜组相当,但术后并发症发生率及术后住院时间具有明显优势,代表了经鼻蝶垂体腺瘤手术的发展方向。更多还原

【Abstract】 Objective:To comparatively analyze the clinical effect of trans-nasal-sphenoidal pituitary adenoma resection under neuroendoscope or microscope.Methods:Retrospective analysis was made on the clinical data of 263 patients with pituitary adenoma who underwent neuroendoscopic or microscopic trans-nasal-sphenoidal operation from Dec.2009 to Dec.2012.The differences in operation duration,volume of blood loss,total-resection rates,postoperative complication rates and mean postoperative hospital stay between 2 groups were compared.Results:The mean operation duration time were(78.7±34.55) min and(66.8±31.32) min in endoscopic and microscopic group respectively,longer operation time was needed in endoscopic group,the difference was significant(P=0.014).The blood-lost volume was(60.6±32.35) ml and(55.1±24.63) ml in endoscopic and microscopic group respectively with no significant differences between these two groups(P=0.943).The total-resection rate of these two groups was 93.3%(98/105) and 92.4%(146/158) respectively,with no significant differences(P=0.7760).The postoperative complication occurring rate in endoscopic group(5.71%) was lower compared with microscopic group(13.29%),which had a significant difference(P=0.0470).The postoperative hospital stay was(6.12±1.94) d and(7.13±1.57) d respectively in endoscopic and microscopic group,with significant difference between these groups(P=0.0166).Conclusions:Although being similar in total resection rates between endoscopic and microscopic operation,neuroendoscopic operation is superior in postoperative complication occurring rates and postoperative hospital stays,which may represent the trends of tans-nasal-sphenoidal pituitary adenoma resection.更多还原