内镜下经鼻蝶入路术治疗颅咽管瘤疗效及其对巨噬细胞炎性蛋白-1α、IL-6、IL-8的影响

摘要

目的 探讨内镜下经鼻蝶入路手术(EETA)治疗颅咽管瘤患者疗效及其对巨噬细胞炎性蛋白-1α(MIP-1α)、白介素-6(IL-6)、白介素-8(IL-8)的影响.方法 选择2012年8月-2016年8月新疆医科大学第一附属医院神经外科中心接受治疗的68例颅咽管瘤患者作为研究对象,按随机数字表法分成EETA组和经颅入路手术(DT-CA)组,各34例.EETA组患者应用神经内镜下经鼻蝶扩大入路手术进行治疗,DTCA组患者则行常规经颅入路手术进行治疗.观察、比较2组患者的手术治疗情况及其治疗前后血清MIP-1 α、IL-6、IL-8水平的变化.结果 EETA组患者的手术时间、术中出血量、肿瘤切除时间及住院时间均明显低/短于DTCA组,2组间比较的差异具有统计学意义(t=16.770、25.865、9.882、4.146,P＜0.01);EETA组患者的垂体柄保留率明显高于DTCA组,2组间比较的差异具有统计学意义(69.6％ vs.40.0％,x2=4.218,P＜0.01);2组患者的血清MIP-1 α、IL-6、IL-8水平均较治疗前显著下降(P＜0.01),并且EETA组患者下降的更为显著(t=7.823、5.002、8.865,P＜0.01);2组患者术后并发症比较差异无统计学意义(P＞0.05).结论 颅咽管瘤患者应用内镜下经鼻蝶入路手术治疗能够获得良好的临床效果,有效降低血清IL-6、IL-8、MIP-1α水平,并且具有较高的安全性,值得加以推广应用.%Objective To analyze and investigate the effects of endoscopic transsphenoidal approach (EETA) surgery on macrophage inflammatory protein and interleukin in patients with craniopharyngioma.Methods Sixty-eight cases of patients with craniopharyngioma were selected,which were treated in the First Affiliated Hospital of Xinjiang Medical University from August 2012 to August 2016,and they were divided into EETA group (34 cases) and DTCA group (34 cases).The patients of EETA group were.treated with EETA.The patients of DTCA group were treated with general Transcranial surgery (DTCA).Observe and compare the surgical treatment and changes of the levels of serum macrophage inflammatory protein 1 α (MIP-1α),interleukin 6 (IL-6),interleukin 8 (IL-8) of two groups.Results The operation time,intraoperative blood loss,tumor resection time and length of stay of EETA group were significantly lower than those of DTCA group (t =16.770,25.865,9.882,4.146,P ＜0.05);The pituitary retention rate of EETA group were significantly higher than those of DTCA group (69.6％ vs.40.0％,x2 =4.218,P ＜0.01);In the terms of serum MIP-1α,IL-6,IL-8,the patients of two groups were all significantly decreased than before (P ＜ 0.05),and the patients of EETA group got more significant decline (t =7.823,5.002,8.865,P ＜ 0.05);there was no statistically significant difference in postoperative complications between the two groups (P ＞ 0.05).Conclusion For treating patients with craniopharyngioma,endoscopic transsphenoidal approach surgery can achieve good clinical results,effectively reduce serum IL-6,IL-8,MIP-1α levels,and it has a high security,which makes it worthy of popularization and application.