神经内镜辅助经蝶显微手术对分泌生长激素的脑垂体腺瘤患者生长激素及预后的影响

摘要

Objective To analyze effects of neuroendoscopy assisted transsphenoidal microsurgery on growth hormone (GH) level and prognosis of patients with growth hormone-secreting pituitary adenoma.Methods A total of 33 patients with growth hormone-secreting pituitary adenoma treated by neuroendoscopy assisted transsphenoidal microsurgery during February 2008 and July 2015 were collected as study group, and 33 patients with growth hormone-secreting pituitary adenoma treated by transsphenoidal microsurgery at the same period were selected as control group.The operative condition, tumor resection rate, GH levels before and after operation, incidence rate of complications and disease recurrence rate were compared between the two groups.Results In study group, operative time was significantly longer;postoperative time of lying in bed and hospitalization time were significantly shorter;total resection rate was significantly higher, and the total incidence rate complications was significantly lower than those in control group (P<0.05).The difference of GH levels before operation between the two groups was not statistically significant (P>0.05);postoperative GH levels were significantly improved compared with those before operation in two groups, and the changes in study group were more superior to that in control group (P<0.05).There was no significant difference in recurrence rates between the two groups by follow-up 1 year later (P>0.05).Conclusion Neuroendoscopy assisted transsphenoidal microsurgery is effective in treatment of patients with growth hormone-secreting pituitary adenoma, and it can shorten postoperative time of lying in bed and hospitalization time, improve GH level, increase tumor total resection rate and decrease total incidence rate of complications.%目的 分析神经内镜辅助经蝶显微手术对分泌生长激素(growth hormone, GH)的脑垂体腺瘤患者GH及预后的影响.方法 选择2008年2月-2015年7月邢台市人民医院收治的采用神经内镜辅助经蝶显微手术治疗的分泌GH的脑垂体腺瘤33例作为研究组,另选择该院同期资料匹配采用经蝶显微手术治疗的分泌GH的脑垂体腺瘤33例作为对照组.统计比较两组手术情况、肿瘤切除率、手术前后GH水平、并发症发生率及疾病复发率.结果 研究组手术时间长于对照组,术后卧床时间及住院时间均短于对照组,肿瘤完全切除率高于对照组,总并发症发生率低于对照组,差异有统计学意义(P<0.05).手术前两组GH水平比较差异无统计学意义(P>0.05);手术后两组GH水平均较手术前显著改善,且研究组明显优于对照组,差异均有统计学意义(P<0.05).术后1年随访,两组疾病复发率比较差异无统计学意义(P>0.05).结论 神经内镜辅助经蝶显微手术治疗分泌GH的脑垂体腺瘤效果显著,可缩短术后卧床及住院时间,改善GH水平,提高肿瘤完全切除率,且总并发症发生率较低.