临床神经外科杂志Issue(2)：134-139,6.DOI:10.3969/j.issn.1672-7770.2019.02.009
经鼻蝶入路神经内镜下垂体瘤切除术的疗效研究
Clinical analysis of endoscopic transsphenoidal pituitary adenoma resection
摘要
Abstract
Objective To investigate the postoperative clinical effect of sphenoid endoscopic surgery in patients with pituitary tumor.Methods The clinical data of 78 patients with pituitary tumor treated by neuro endoscopic surgery via endonasal transsphenoidal approach in Shanxi Grand Hospital from March 2012 to October 2017 were analyzed retrospectively.The clinical data of patients and the changes of clinical indexes before and after operation were compared and analyzed . Results The surgical resection rate of transsphenoidal pituitary adenoma was mainly related to tumor volume and invasion.The larger volume of invasive tumor led to the lower surgical resection rate.The postoperative hormone levels of RPL adenoma and GH adenoma with different tumor size and degree of resection showed a decreasing trend.The preoperative and postoperative difference was statistically significant (P＜0.001).Of 78 patients, 6 had cerebrospinal fluid leakage , 10 had transient diabetes insipidus , 8 had high fever and electrolyte disorder , 2 had pituitary function subnomorlity, 3 had nasal hemorrhage and 1 had vision loss.All patients improved after symptomatic treatment.After operation, 36 patients had headache relief , 28 had vision improvement, 3 had finger flexibility improvement and 40 hormone level of tumors decreased or fully recovered and the related symptoms improvement.After 3 months operation , the MRI results showed that 61 cases were total resection (78.2%), 11 were subtotal resection (14.1%) and 6 (7.7%) were partially resected.Endocrine test results showed that the level of prolactin in 29 patients with PRL type pituitary tumor decreased or returned to normal compared to preoperative , and the growth hormone level of 40 patients with GH pituitary tumor decreased or returned to normal before operation.Conclusion The clinical treatment of patients with endoscopic pituitary tumor resection is remarkable, which is a less traumatic, safe and effective treatment method.It is worth popularizing and applying.关键词
垂体腺瘤/神经内镜/经鼻蝶入路Key words
pituitary adenoma / neuroendoscope / transsphenoidal approach分类
医药卫生引用本文复制引用
ZHOU Teng-yuan,CHEN Lai-zhao,NIU Xiao-min,et al..经鼻蝶入路神经内镜下垂体瘤切除术的疗效研究[J].临床神经外科杂志,2019,(2):134-139,6.基金项目
山西省重点研发计划项目(201803D31165) （201803D31165）
