[1]周腾渊,陈来照,牛小敏,等.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,2019,16(2):134-141.[doi:10.3969/j.issn.1672-7770.2019.02.009]
 ZHOU Teng-yuan,CHEN Lai-zhao,NIU Xiao-min,et al.Clinical analysis of endoscopic transsphenoidal pituitary adenoma resection[J].Journal of Clinical Neurosurgery,2019,16(2):134-141.[doi:10.3969/j.issn.1672-7770.2019.02.009]
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经鼻蝶入路神经内镜下垂体瘤切除术的疗效研究()
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《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
16
期数:
2019年第2期
页码:
134-141
栏目:
垂体瘤专题
出版日期:
2019-04-17

文章信息/Info

Title:
Clinical analysis of endoscopic transsphenoidal pituitary adenoma resection
作者:
周腾渊陈来照牛小敏任斌贾禄白东
032200 汾阳,山西省汾阳医院神经外科 (周腾渊); 山西医学科学院 山西大医院神经外科(陈来照,牛小敏,任斌,白东);山西省人民医院(贾禄)
Author(s):
ZHOU Teng-yuan CHEN Lai-zhao NIU Xiao-min et al.
Department of Neurosurgery, Fenyang Hospital of Shanxi Province, Fenyang 032200, China
关键词:
垂体腺瘤神经内镜经鼻蝶入路
Keywords:
pituitary adenoma neuroendoscope transsphenoidal approach
分类号:
R739.41
DOI:
10.3969/j.issn.1672-7770.2019.02.009
文献标志码:
A
摘要:
【摘要】目的 研究经鼻蝶神经内镜下垂体瘤切除手术的临床疗效。方法回顾性分析山西大医院神经外科2012年3月—2017年10月,收治的78例经鼻蝶内镜手术垂体瘤患者的临床资料。对比分析不同肿瘤大小、侵袭性及类型患者手术前后各项临床指标的变化。结果垂体腺瘤手术切除率与肿瘤体积和是否为侵袭性有关。侵袭性肿瘤和肿瘤体积越大者,手术切除率越低。不同肿瘤大小和切除程度的泌乳素(prolactin,RPL)型和生长激素(growth hormone, GH)型腺瘤患者术后的血激素水平均明显下降,与术前的差异有统计学意义(P<0.05-0.001)。78例患者中,术后并发脑脊液漏者6例、临时性尿崩者10例、高热及电解质紊乱者8例、垂体功能低下2例、鼻出血3例、视力减退1例;经相应对症处理后均缓解或好转。术后,36例患者头痛缓解,28例患者视力、视野改善,3例患者手指灵活度改善;40例患者血清激素水平降低或恢复正常,相关症状好转。术后3个月复查MRI显示,肿瘤全切者61例(全切除率78.2%),次全切者11例(14.1%),大部分切除者6例(7.7%)。血清激素水平检测显示,29例PRL型垂体瘤患者的PRL水平,以及40例GH型垂体瘤患者的GH水平分别较术前降低或恢复正常。结论经鼻蝶神经内镜下垂体瘤切除术的临床疗效显著;是一种创伤较小、安全有效的手术方式,值得推广应用。
Abstract:
Abstract: ObjectiveTo investigate the postoperative clinical effect of sphenoid endoscopic surgery in patients with pituitary tumor. MethodsThe 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. ResultsThe 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. ConclusionThe 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.

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 HUI Wei-ning,SHAO Guo-ping,HUANG Wei,et al.Clinical and pathological study on resection of pseudocapsule of pituitary adenoma by neuroendoscopy[J].Journal of Clinical Neurosurgery,2018,15(2):308.

更新日期/Last Update: 2019-04-17