CAJ | 학술논문

【目的】探讨显微镜和神经内镜下单鼻孔经蝶窦对侵袭性垂体腺瘤的手术效果。【方法】选择本院2013年1月至2013年9月收治的60例侵袭性垂体腺瘤患者作为研究对象，按照随机数字表法将患者分为两组。其中，观察组30例患者采用神经内镜下单鼻孔经蝶窦入路手术，对照组30例患者采用显微镜下单鼻孔经蝶窦入路手术，比较两组患者的治疗效果。【结果】观察组患者的手术时间、术中出血量和术后住院时间等指标均明显优于对照组患者，且两组相比较差异均具有显著性（ P ＜0．05），而组间的视力改善率和肿瘤全切率相比较差异无显著性（ P ＜0．05）。手术后，对照组患者的鼻中隔缺损率和鼻窦感染率均明显高于观察组患者，对照组患者的并发症发生率合计为73．3％（22/30），明显高于观察组20％（6/30），且两组相比较差异均具有显著性（ P ＜0．05）。【结论】采用神经内镜下单鼻孔经蝶窦入路术式对侵袭性垂体腺瘤具有十分显著的治疗效果，其手术时间较短，术中出血量较少，且缩短了患者术后住院时间，降低了术后并发症的发生率，有利于患者的术后恢复。
【목적】탐토현미경화신경내경하단비공경접두대침습성수체선류적수술효과。【방법】선택본원2013년1월지2013년9월수치적60례침습성수체선류환자작위연구대상，안조수궤수자표법장환자분위량조。기중，관찰조30례환자채용신경내경하단비공경접두입로수술，대조조30례환자채용현미경하단비공경접두입로수술，비교량조환자적치료효과。【결과】관찰조환자적수술시간、술중출혈량화술후주원시간등지표균명현우우대조조환자，차량조상비교차이균구유현저성（ P ＜0．05），이조간적시력개선솔화종류전절솔상비교차이무현저성（ P ＜0．05）。수술후，대조조환자적비중격결손솔화비두감염솔균명현고우관찰조환자，대조조환자적병발증발생솔합계위73．3％（22/30），명현고우관찰조20％（6/30），차량조상비교차이균구유현저성（ P ＜0．05）。【결론】채용신경내경하단비공경접두입로술식대침습성수체선류구유십분현저적치료효과，기수술시간교단，술중출혈량교소，차축단료환자술후주원시간，강저료술후병발증적발생솔，유리우환자적술후회복。
To explore the efficacy of microscopic vs .neuroendoscopic single nostril transsphe-noidal approach surgical methods for the treatment of invasive pituitary adenomas .[Methods]Totally 60 pa-tients with invasive pituitary adenoma in our hospital from Jan .2013 to Sept .2013 were enrolled in the study . All patients were randomly divided into two groups .The observation group( n =30) underwent neuroendo-scopic single nostril transsphenoidal approach surgery ,while the control group( n=30) underwent microscop-ic single nostril transsphenoidal approach surgery .The efficacy was compared between two groups .[Results]The operation time ,intraoperative blood loss ,postoperative hospital stay and other indicators in observation group were obviously better than the control group ,and there was significant difference between two groups ( P <0 .05) ,but there was no significant difference in vision improvement and total tumor resection rate be-tween two groups( P >0 .05) .After operation ,nasal septum defect and sinus infection rate in control group were obviously higher than those in observation group .The incidence rate of total complications in control group was 73 .3 % (22/30) which was obviously higher than that in observation group(20% ,6/30) ,and there was significant difference( P <0 .05) .[Conclusion] Neuroendoscopic single nostril transsphenoidal approach surgery for the treatment of invasive pituitary adenoma has very significant efficacy with short operation time , less intraoperative blood loss ,and can shorten postoperative hospitalization time and reduce the incidence of postoperative complications ,and is helpful for the patients'recovery .