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目的探讨不同微创手术方案经鼻蝶治疗垂体瘤的疗效。方法选取2012年1月至2014年9月间收治的160例垂体瘤患者,采用随机数表法分为观察组和对照组,各80例。观察组患者采用神经内镜下经鼻蝶治疗,对照组患者采用显微镜下经鼻蝶治疗。对比两组患者的全切率、手术时间、术中出血量、住院时间、术后并发症和术后一周各激素回落情况。结果两组患者全切率差异无统计学意义(P>0.05)。观察组患者术中出血量和住院时间均低于对照组患者,观察组患者手术时间长于对照组,差异有统计学意义(P<0.05)。观察组患者术后一周各项激素水平基本回落至正常范围或略微高于正常范围内,回落情况优于对照组患者,差异有统计学意义(P<0.05)。观察组和对照组患者术后并发症的总发生率分别为15.0%和60.0%,差异有统计学意义(P<0.05)。结论垂体瘤患者神经内镜下经鼻蝶治疗虽然手术时间略长,但对患者造成的创伤较小,术后并发症发生率较低,恢复较快,可以推广使用。
Objective To explore the efficacy of different minimally invasive surgical approaches for the treatment of pituitary tumors by nasal butterfly. Methods A total of 160 patients with pituitary adenoma treated between January 2012 and September 2014 were randomly divided into observation group and control group, 80 cases each. Patients in the observation group were treated with a transnasal butterfly under a neuroendoscope, and patients in the control group were treated with a transnasal butterfly under a microscope. The total cut rate, operation time, intraoperative blood loss, length of hospital stay, postoperative complications, and drop of hormones after one week were compared between the two groups. Results There was no significant difference in total removal rate between the two groups (P>0.05). The intraoperative blood loss and length of stay in the observation group were lower than those in the control group. The observation time was longer in the observation group than in the control group (P<0.05). In the observation group, the hormone levels of the observation group dropped back to the normal range or slightly higher than the normal range after a week, and the decline was better than that of the control group. The difference was statistically significant (P<0.05). The total incidence of postoperative complications in the observation group and the control group were 15.0% and 60.0%, respectively, and the difference was statistically significant (P<0.05). Conclusion Although the operation time of the transnasal endoscopic treatment of pituitary adenomas is slightly longer, the trauma to the patient is smaller, the incidence of postoperative complications is lower, and the recovery is faster. It can be widely used.