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神经内镜经鼻蝶手术治疗垂体腺瘤的随机对照试验研究

A randomized control trial of neuroendoscopic transsphenoidal surgery for treating pituitary adenomas

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【作者】 樊宇耕寇欣白小飞杨海贵

【Author】 FAN Yu-geng;KOU Xin;BAI Xiao-fei;YANG Hai-gui;Department of Neurosurgery,Yan’an People’s Hospital;

【通讯作者】 寇欣;

【机构】 延安市人民医院神经外科

【摘要】 目的评价神经内镜经鼻蝶手术治疗垂体腺瘤的疗效。方法本研究将80例垂体腺瘤患者随机分为观察组和对照组,每组各40例。观察组的患者给予神经内镜经鼻蝶手术治疗,对照组患者给予显微镜经鼻蝶手术治疗。评价两组患者的肿瘤全切率、手术时间、术后鼻腔通畅率和术后复发率、以及术后患者的催乳素、生长激素和促肾上腺皮质激素水平变化情况。结果观察组患者的肿瘤全切率为17 (42. 50%)、手术时间为(88. 41±10. 94) min、术后鼻腔通畅率为33(82. 50%)以及术后复发率为3(7. 50%);对照组患者的肿瘤全切率为5(12. 50%)、手术时间为(129. 18±19. 25) min、术后鼻腔通畅率为4(10. 0%)以及术后复发率为11(27. 5%)。两组比较,各指标差异有统计学意义。另外,观察组患者术后的催乳素、生长激素和促肾上腺皮质激素水平分别为(1. 32±0. 54) nmol/L、(0. 63±0. 17) nmol/L和(9. 43±2. 58) pmol/L,显著低于对照组的(3. 13±0. 85) nmol/L、(1. 41±0. 38) nmol/L和(16. 13±3. 30) pmol/L。结论神经内镜经鼻蝶手术治疗垂体腺瘤的疗效优于显微镜经鼻蝶手术,可作为垂体腺瘤手术治疗的首选方法。

【Abstract】 Objective To assess the effectiveness of neuroendoscopic transsphenoidal surgery( NTS) for the treatment of pituitary adenomas( PA). Methods A total of 80 PA patients were randomly divided into the observation group and the control group,each group 40 cases. The patients in the observation group received NTS,while the patients in the control group received microendoscopic transsphenoidal surgery( MTS). The outcomes included total tumor removal rate,operation time,postoperative nasal patency,and postoperative recurrence rate,as well as the changes in levels of prolactin,growth hormone,and adrenocorticotropic hormone in postoperative patients. Results The total tumor removal rate,operation time,postoperative nasal patency,and postoperative recurrence rate were 17( 42. 50%),( 88. 41 ±10. 94) min,33( 82. 50%),and 3( 7. 50%) in the observation group. In the control group they were 5( 12. 50%),( 129. 18 ±19. 25) min,4( 10. 0%),and 11( 27. 5%). Significant differences were found between two groups. After surgery,the levels of prolactin,growth hormone,and adrenocorticotropic hormone were( 1. 32 ± 0. 54)nmol/L,( 0. 63 ± 0. 17) nmol/L,and( 9. 43 ± 2. 58) pmol/L respectively in the observation group,which were sig nificant lower than( 3. 13 ± 0. 85) nmol/L,( 1. 41 ± 0. 38) nmol/L,and( 1 6. 1 3 ± 3. 3 0) pmol/L in the control group. Conclusion The efficacy of NST is superior to the MST for the treatment of PA,which should be recommended as the first choice for PA therapy.

  • 【文献出处】 延安大学学报(医学科学版) ,Journal of Yanan University(Medical Science Edition) , 编辑部邮箱 ,2018年03期
  • 【分类号】R736.4
  • 【被引频次】4
  • 【下载频次】46
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