单鼻孔经鼻蝶垂体腺瘤内镜手术与显微镜手术疗效的对比研究

发布时间：2018-10-24 08:06

【摘要】：目的:探讨内镜手术与显微镜手术在切除垂体腺瘤的有效性及安全性上相比较哪个更具有优势,为以后治疗垂体瘤手术方式选择上提供帮助。方法:对新疆医科大学第一附属医院神经外科自2001年1月至2015年06月单鼻孔经蝶垂体腺瘤内镜手术或显微镜手术患者进行历史对照分析。其中单鼻孔经蝶内镜手术组379例,单鼻孔经蝶显微镜下手术组418例患者。比较两种手术方式的安全性及有效性。两组定量资料比较用t检验,两组定性资料用卡方检验。结果:肿瘤全切率上两组在微腺瘤加大腺瘤未向鞍旁生长同时也没有侵犯海绵窦比较差异没有统计学意义(P0.05);在术后视力恢复上,内镜组与显微镜组比较差异没有统计学意义(P0.05);术后内分泌恢复情况上,两组生长激素值恢复正常比较有显著统计学差异(t=7.924,P0.05),而在皮质醇及泌乳素值恢复上两组比较无统计学差异(P0.05);两组术后总的并发症及复发率(随访2年)比较上无统计学意义(P0.05);两组病例在手术时间比较上无显著差异(P0.05),而在术后住院天数对比上有显著性差异(P0.05);由此可知在术后生长激素值恢复、术后住院时间上内镜组优于显微镜组。结论:显微镜下和神经内镜在单鼻孔入路经蝶切除垂体腺瘤时内镜手术略优于显微镜手术,术者应积极结合两种术式优点,争取最好的治疗效果。
[Abstract]:Objective: to explore the advantages of endoscopic surgery and microsurgery in the treatment of pituitary adenoma. Methods: the history of single nostril transsphenoidal pituitary adenoma endoscopic surgery or microsurgery was analyzed in the first affiliated Hospital of Xinjiang Medical University from January 2001 to June 2015. There were 379 cases in single nostril transsphenoidal surgery group and 418 cases in single nostril transsphenoidal microsurgery group. To compare the safety and effectiveness of two surgical methods. T test was used to compare the quantitative data and chi-square test was used to analyze the qualitative data. Results: there was no significant difference in tumor total removal rate between the two groups in microadenoma enlargement adenoma and no invasion of cavernous sinus at the same time (P0.05). There was no significant difference between the endoscopic group and the microscope group (P0.05). There was significant difference in the recovery of growth hormone between the two groups (t = 7.924), but there was no significant difference between the two groups in the recovery of cortisol and prolactin (P0.05), the total postoperative complications and recurrence rate (2 years follow-up) in the two groups had no significant difference (P 0.05), but there was no significant difference between the two groups in the recovery of cortisol and prolactin (P0.05). There was no significant difference in operation time between the two groups (P0.05), but there was significant difference in postoperative hospitalization days (P0.05). Postoperative hospitalization time in endoscopic group was better than that in microscope group. Conclusion: endoscopic surgery under microscope and neuroendoscopy is slightly superior to microscope in the transsphenoidal resection of pituitary adenoma. The best therapeutic effect should be achieved by combining the advantages of the two methods.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R736.4

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