神经内镜下经鼻—蝶入路垂体瘤切除术：单鼻孔与双鼻孔入路的对比研究

发布时间：2018-06-18 14:15

本文选题：单鼻孔 + 双鼻孔　；参考：《重庆医科大学》2017年硕士论文

【摘要】：目的比较神经内镜下经单鼻孔和双鼻孔-蝶窦入路切除垂体瘤的临床疗效及安全性。方法回顾2012年05月到2016年12月在我院接受神经内镜下经鼻-蝶窦入路垂体瘤切除术80例患者的临床资料,其中经单鼻孔入路45例,经双鼻孔入路35例,比较两组患者的肿瘤切除率、临床症状及内分泌水平的改善情况、手术并发症(脑脊液漏、鼻衄、颅内感染、尿崩等)。结果对于垂体微腺瘤、蝶鞍内的垂体大腺瘤以及部分向鞍外侵袭的垂体大腺瘤,两组的肿瘤切除率、激素水平以及视力改善等无明显差异,但单鼻孔组的并发症相对较少;对于明显向鞍外侵袭的垂体巨大腺瘤,双鼻孔组的肿瘤切除程度则高于单鼻孔组。结论单鼻孔入路方式适合绝大部分的垂体微腺瘤以及部分垂体大腺瘤,双鼻孔入路方式更适合明显向鞍外侵袭的垂体巨大腺瘤。
[Abstract]:Objective to compare the clinical efficacy and safety of endoscopic single nostril and double nostril-sphenoid sinus approach in the resection of pituitary adenomas. Methods from May 2012 to December 2016, 80 patients with pituitary adenoma underwent endoscopic transsphenoidal approach in our hospital, including 45 patients with single nostril approach and 35 patients with double nostril approach. The rate of tumor resection, the improvement of clinical symptoms and endocrine level, the complications of operation (cerebrospinal fluid leakage, epistaxis, intracranial infection, urinal avalanche, etc.) were compared between the two groups. Results there was no significant difference in tumor resection rate, hormone level and visual acuity between the two groups for pituitary microadenomas, pituitary macroadenomas in Sella turcica and some pituitary macroadenomas invading out of the Sella, but the complications in the single nostril group were relatively small. For the giant pituitary adenoma with obvious extraSellar invasion, the resection degree of the tumor in the double nostril group was higher than that in the single nostril group. Conclusion the single nostril approach is suitable for most pituitary microadenomas and some large pituitary adenomas, while the double nostril approach is more suitable for the large pituitary adenomas with obvious invasion out of the saddle.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R736.4

【参考文献】