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目的探讨经蝶窦入路手术与传统开颅手术切除垂体瘤的临床疗效。方法 105例垂体瘤患者按照手术方式的不同分为观察组54例和对照组51例。观察组采用经蝶窦入路垂体瘤切除术,对照组采用传统开颅手术。观察2组手术时间、术中出血量、下床时间、住院时间和肿瘤全切率,综合疗效,术后空腹血糖水平、汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)评分、数字分级法(NRS)疼痛程度评分,及术后并发症情况。结果观察组肿瘤全切率高于对照组,差异有统计学意义(P<0.01);观察组手术时间、术中出血量、下床时间、住院时间均显著小于对照组,差异有统计学意义(P<0.01);观察组综合疗效为优的比例高于对照组,优良率亦高于对照组,差异有统计学意义(P<0.05);观察组鼻腔出血、电解质紊乱的发生率显著低于对照组,差异有统计学意义(P<0.05,P<0.01)。结论与传统开颅手术相比,经蝶窦入路手术切除垂体瘤具有创伤小、切除彻底、综合疗效好、术后应激反应程度低、并发症少的优势。
Objective To investigate the clinical efficacy of transsphenoidal approach and conventional craniotomy for pituitary tumor resection. Methods 105 cases of pituitary adenoma were divided into observation group (n = 54) and control group (n = 51) according to different surgical methods. The observation group was treated by transnasal pituitary tumor resection, while the control group was treated by conventional craniotomy. The operative time, intraoperative blood loss, time to bed, length of hospital stay, tumor resection rate, comprehensive efficacy, postoperative fasting blood glucose, HAMD and HAMA scores were observed. Grading (NRS) pain score, and postoperative complications. Results The total tumor resection rate in the observation group was significantly higher than that in the control group (P <0.01). The operation time, blood loss, time to bed and hospital stay in the observation group were significantly lower than those in the control group (P <0.01). The ratio of excellent curative effect in the observation group was higher than that in the control group, and the excellent and good rate was also higher than that of the control group (P <0.05). The incidence of nasal bleeding and electrolyte disturbance in observation group was significantly lower In the control group, the difference was statistically significant (P <0.05, P <0.01). Conclusions Compared with the traditional craniotomy, transsphenoidal approach for the resection of pituitary adenoma has the advantages of less trauma, complete resection, better curative effect, less postoperative stress response and fewer complications.