显微镜与神经内镜下单鼻孔经蝶窦手术入路切除垂体腺瘤的效果观察

摘要

Objective To campare the effects of pituitary adenoma resection by trans - single nosril and transsphenoidal approach between through the microsope and endosope.Methods The clinical data of 156 case who taken pituitary adenoma resection by trans -single nostil and transsphenoidal approach were analyzed.61 cases taken operation through microsope and 95 cases taken operation through endoscope.Results Total tumor removal rates through microscope and endoscope were 83.6％ and 84.2％ respectively ( x2 = 0.010,P ＞ 0.05 ); the operation time were ( 83.6 ± 13.7 ) mintues and ( 113.8 ± 16.3 ) mintues respectively ( Z = - 3.202, P ＜ 0.05 ); during surgery the incidence of cerebrospinal fluid leakage , the incidence of postoperative diabetes insipidus , the leakage rates of cerebrospinal fluid and the average hospital days showed no significant difference between two operation methods ;the ratios of reside tumor were diagnosed by MRI after 3 months and 6 months was 18.1％ and 16.8％ respectively ( x2 =0.037 ,P ＞0.05).Conclusion The effects of pituitary adenoma resection by trans -single nostril and transsphenoidal approach through the microscope and endoscope showed no different.%目的 比较显微镜与神经内镜下单鼻孔经蝶窦手术入路切除垂体腺瘤的手术效果.方法 回顾性总结同期61例采用显微镜下及95例采用神经内镜下单鼻孔经蝶窦入路切除垂体腺瘤的临床资料,对比分析各疗效指标.结果 显微镜组与内镜组的肿瘤全切率分别是83.6%和84.2%(x2=0.010,P＞0.05);平均手术时间分别是(83.6±13.7)min和(113.8±16.3)min(Z=-3.202,P＜0.05);术中脑脊液漏发生率、术后尿崩发生率、术后脑脊液漏发生率、术后平均住院天数差异均无统计学意义,术后3到6个月复查MRI明确肿瘤残留率分别是18.1%和16.8%(x2=0.037,P＞0.05).结论 显微镜与神经内镜下单鼻孔经蝶窦手术入路切除垂体腺瘤的手术效果相同.