【摘要】 目的探讨内镜和显微手术对垂体腺瘤患者术后血清基质金属蛋白酶-9(MMP-9)、胰岛素样生长因子-1(IGF-1)及激素相关指标水平的影响。方法以随机数值表法将2017年1月—2020年1月邯郸市中心医院神经外科收治的96例垂体腺瘤患者均分为内镜组(神经内镜下行肿瘤切除)和显微镜组(显微镜下行肿瘤切除)。记录两组手术指标及术后并发症情况;于术前、术后第3天检测血清MMP-9、IGF-1、泌乳素(PRL)、生长激素(GH)及促肾上腺皮质激素(ACTH)水平。结果与显微镜组相比,内镜组的手术时间更长,肿瘤切除程度更优,差异有统计学意义(P<0.05)。术后内镜组的血清MMP-9、IGF-1及PRL、GH及ACTH水平均低于内镜组,差异有统计学意义(P<0.05)。内镜组、显微镜组术后并发症总发生率为10.42%、27.08%,两者差异无统计学意义(P>0.05)。结论神经内镜手术时间较显微镜更长,但在瘤体的清除、降低术后血清MMP-9、IGF-1及激素指标水平方面更具优势。[国际神经病学神经外科学杂志, 2021, 48(6):538-541.]更多还原

【Abstract】 Objective To investigate the effect of endoscopy versus microsurgery on the serum levels of matrix metalloproteinase-9(MMP-9),insulin-like growth factor-1(IGF-1),and hormone-related indices after surgery in patients with pituitary adenoma.Methods A total of 96 patients with pituitary adenoma who were admitted to Department of Neurosurgery,Handan Central Hospital,from January 2017 to January 2020 were divided into endoscopy group(neuroendoscopic tumor resection)and microsurgery group(microscopic tumor resection)using a random number table. Surgical indices and postoperative complications were recorded for the two groups,and the serum levels of MMP-9,IGF-1,prolactin(PRL),growth hormone(GH),and adrenocorticotropic hormone(ACTH)were measured before surgery and on day 3 after surgery.Results Compared with the microsurgery group,the endoscopy group had a significantly longer time of operation and a significantly better degree of tumor resection(P <0.05). Compared with the microsurgery group after surgery,the endoscopy group had significantly lower serum levels of MMP-9(72.39±10.53 μg/L vs 80.18±13.42 μg/L,P <0.05),IGF-1(298.64±42.75 ng/m L vs 319.61±41.96 ng/m L,P <0.05),PRL(1.36±0.44 nmol/L vs 1.67±0.53 nmol/L,P <0.05),GH(0.96±0.28nmol/L vs 1.39±0.37 nmol/L,P <0.05),and ACTH(4.28±0.72 nmol/L vs 4.85±0.74 nmol/L,P <0.05). There was no significant difference in the overall incidence rate of postoperative complications between the endoscopy group and the microsurgery group(10.42% vs 27.08%,P >0.05).Conclusions Compared with microsurgery,neuroendoscopic surgery has a longer time of operation and advances in reducing the serum levels of MMP-9,IGF-1,and hormone-related indices after surgery.[Journal of International Neurology and Neurosurgery, 2021, 48(6): 538-541.]更多还原