内镜辅助下经鼻蝶入路手术治疗垂体瘤的临床效果分析

摘要

Objective To investigate the clinical efficacy of endoscopic assisted by transsphenoidal surgery for pituitary tumors.Methods 90 cases of patients with pituitary tumors were randomly divided into the control group ( nasal vestibule-sep-tum-sphenoid resection of pituitary tumors ) and the observation group ( endoscopic assisted transsphenoidal approach surgery ) , each with 45 cases.Blood loss,residual tumor,degree of reduced tumor volume and hormone decline ratio of the 2 groups were compared.Results In the observation group,blood loss,reduced tumor volume and hormone level decreased rates were (83.9 ± 11.7) ml,(90.3 ±12.2)%,(85.9 ±12.1)%,and the control group were [(351.2 ±42.8) ml,(53.7 ±7.4)%,(41.9 ± 8.6)%],the difference was statistically significant,P<0.05;in the observation group,residual tumor rate(4.4%) was signifi-cantly lower than the control group (31.1%),there had statistically significant difference ,P<0.05.Excellent rate in the observa-tion group was significantly higher ,and postoperative complications was significantly less than the control group ,the difference was statistically significant,P<0.05.Conclusion Endoscopic assisted transsphenoidal surgery for pituitary tumors is significantly better than the nasal vestibule-septum-sphenoid resection ,it has higher security ,and it is worthy of promotion .%目的：探讨垂体瘤患者采用内镜辅助下经鼻蝶入路手术治疗的临床疗效。方法选取90例垂体瘤患者，按照随机数字表法分为对照组（经鼻前庭-鼻中隔-蝶窦垂体瘤切除术）与观察组（内镜辅助下经鼻蝶入路手术），各45例。比较两组患者术中出血量、肿瘤残留、肿瘤体积缩小程度及内分泌激素下降比例。结果观察组术中出血量和肿瘤体积缩小程度及内分泌激素下降比例分别为（83．9±11．7） ml、（90．3±12．2）％、（85．9±12．1）％，与对照组[（351．2±42．8） ml、（53．7±7．4）％、（41．9±8．6）％]比较，差异具有统计学意义，P＜0．05；观察组肿瘤残留率（4．4％）明显低于对照组（31．1％），差异具有统计学意义，P＜0．05。观察组治疗优良率明显高于对照组，而术后并发症明显少于对照组，差异具有统计学意义，P＜0．05。结论应用内镜辅助下经鼻蝶入路手术治疗垂体瘤疗效明显优于经鼻前庭-鼻中隔-蝶窦垂体瘤切除术，且具有较高安全性，因此可值得推广应用。