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目的比较经鼻蝶神经内镜垂体腺瘤切除术与经鼻蝶神经显微镜垂体瘤切除术的手术疗效。方法选取2014年5月~2016年5月收治的162例垂体腺瘤患者纳入研究,其中经鼻蝶神经内镜手术74例,经鼻蝶神经显微镜手术88例,比较两组患者的术中脑脊液(CSF)漏发生率、术后CSF漏率、术后并发症发生率、手术时间、住院时间等指标。结果两组患者的年龄、性别及病程差异无统计学意义。神经内镜组CSF漏发生率为35.1%,显微镜组术中CSF漏发生率20.5%,内镜组CSF漏的发生率高于显微镜组(P<0.05);神经内镜组手术时间为(185.0±53.8)min,显微镜组为(123.9±64.3)min,内镜组手术时间明显长于显微镜组(P<0.05);两组在术后CSF漏发生率、并发症发生率、住院时间差异无统计学意义(P>0.05)。结论经鼻蝶神经内镜垂体腺瘤切除术与显微镜手术相比疗效相当,但内镜手术具有视野好、照明优、全切率高、损伤小等优点,适宜在临床上广泛应用。
Objective To compare the surgical outcomes of transsphenoidal pituitary adenoma resection and transsphenoidal nerve pituitary adenoma resection. Methods A total of 162 patients with pituitary adenoma who were admitted to our hospital from May 2014 to May 2016 were enrolled. Among them, 74 cases were treated by endoscopic nasal endoscopy and 88 cases were treated by nerve microscopy with nasalis nerve. The operative cerebrospinal fluid (CSF) leakage rate, postoperative CSF leakage rate, the incidence of postoperative complications, operation time, hospital stay and other indicators. Results There was no significant difference in age, sex and course of disease between the two groups. The incidence of CSF leakage in the endoscopic group was 35.1%, the incidence of CSF leakage in the group of endoscopic microscope was 20.5%, the incidence of CSF leakage in the endoscopic group was higher than that in the microscope group (P <0.05) ± 53.8) min. The time of operation in the endoscopic group was significantly longer than that of the microscope group (123.9 ± 64.3) min. There was no statistical difference in the incidence of postoperative CSF leakage, complication rate and hospital stay Significance (P> 0.05). Conclusions Transnasal endoscopic pituitary adenoma resection is equivalent to microsurgical resection. However, endoscopic surgery has the advantages of good field of vision, superior illumination, high total cut rate and small damage. It is suitable for clinical application.