显微镜和内镜下经鼻蝶垂体瘤切除术的对比研究

发布时间：2018-03-28 06:09

  本文选题：神经内镜　切入点：显微镜　出处：《浙江大学》2017年硕士论文

【摘要】：研究目的:比较显微镜和神经内镜下经鼻蝶垂体瘤切除术的优劣。研究方法:选取我院(浙江大学医学院附属邵逸夫医院神经外科)同一医疗小组2008年1月-2016年12月期间显微镜下经鼻蝶垂体瘤切除术病例63例作为显微镜组,神经内镜下经鼻蝶垂体瘤切除术病例85例作为内镜组。统计两组病例的患者年龄、性别、肿瘤切除情况、手术时间、术后住院时间及术后并发症(尿崩症、脑脊液漏、感染、颅内出血、鼻出血)等数据,运用SPSS软件进行分析,计量资料以均数±标准差(x±S)采用t检验;计数资料以率(%)表示,采用χ2检验,P0.05有统计学意义。结果:全切率神经内镜组比显微镜组高(91.8%VS 76.2%),χ2=6.935,p=0.008,有显著性差异;手术时间神经内镜组比显微镜组短(113.18±36.38minVS 134.37±57.31min),t=2.575,p=0.012,有显著性差异;术后住院时间神经内镜组比显微镜组短(7.02±2.37天VS 8.00±2.78天),t=2.293,p=0.023,有显著性差异;术后并发症:脑脊液漏发生率神经内镜组比显微镜组高(3.5%VS 1.6%),χ2=0.519,p=0.471,无显著性差异;尿崩症发生率神经内镜组比显微镜组低(1.2%VS3.2%),χ2=0.727,p=0.394,无显著性差异;感染发生率神经内镜组比显微镜组低(1.2%VS1.6%),χ2=0.046,p=0.831,无显著性差异;出血发生率神经内镜组比显微镜组低(0%VS 1.6%);鼻出血发生率神经内镜组比显微镜组高(9.4%VS 1.6%),χ2=3.879,p=0.049,有显著性差异。结论:神经内镜下经鼻蝶垂体瘤切除术对比显微镜下经鼻蝶垂体瘤切除术,肿瘤全切率高,手术时间短,术后住院时间短,尿崩症、感染、出血发生率低,但脑脊液漏、鼻出血发生率高。总体来说神经内镜下经鼻蝶垂体瘤切除术优于显微镜下经鼻蝶垂体瘤切除术。
[Abstract]:Objective: to compare the advantages and disadvantages of transsphenoidal pituitary adenoma resection under microscope and endoscope. Methods: the same medical team was selected from January 2008 to 2016 in our hospital (run run run Shaw Hospital affiliated to Zhejiang University School of Medicine). A total of 63 patients underwent transsphenoidal pituitary adenoma resection under microscope for 12 months. Eighty-five patients with endoscopic transsphenoidal pituitary adenoma were treated as endoscopic group. Age, sex, tumor resection, operation time, postoperative hospital stay and postoperative complications (diabetes insipidus, cerebrospinal fluid leakage, infection) were analyzed. The data of intracranial hemorrhage and epistaxis were analyzed by SPSS software. The measurement data were measured by mean 卤standard deviation (x 卤S) using t test, and the counting data were expressed by rate. Results: the total removal rate of neuroendoscopy group was 91.8% higher than that of the microscope group (P < 0.05), and there was significant difference between the two groups, and the operative time was 113.18 卤36.38minVS 134.37 卤57.31 min (t 2.575min), there was significant difference between the two groups (P < 0.05). Postoperative hospitalization time in the endoscopic group was 7.02 卤2.37 days shorter than that in the microscope group (8.00 卤2.78 days), there was significant difference in postoperative complications: the incidence of cerebrospinal fluid leakage in the endoscopic group was higher than that in the microscope group, and there was no significant difference in the incidence of cerebrospinal fluid leakage between the endoscopic group and the microscope group (蠂 2, 0.519, p 0.471). The incidence of diabetes insipidus in the endoscopic group was 1.2VS3.2significantly lower than that in the microscope group, and there was no significant difference in the incidence of infection between the endoscopic group and the microscope group, and the incidence of infection in the endoscopic group was lower than that in the microscope group, and the incidence of infection in the endoscopic group was lower than that in the microscope group, and there was no significant difference in the incidence of infection between the endoscopic group and the microscope group. The incidence of hemorrhage in the endoscopic group was lower than that in the microscope group, and the incidence of epistaxis in the endoscopic group was 9.4VS1.60.There was a significant difference between the endoscopic group and the microscope group. Conclusion: the endoscopic transsphenoidal pituitary adenoma resection was compared with the microscopically transsphenoidal pituitary adenectomy. The total resection rate of tumor is high, the operation time is short, the hospitalization time is short, the incidence of diabetes insipidus, infection and bleeding is low, but cerebrospinal fluid leakage, The incidence of epistaxis is high. Generally speaking, endoscopic transsphenoidal pituitary adenoma resection is superior to microscopically transsphenoidal pituitary adenoma resection.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R736.4
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本文编号：1675073