中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2013年
6期
589-592
,共4页
王清%鲁晓杰%钱硕%苗增利%季卫阳%李兵%汪璟
王清%魯曉傑%錢碩%苗增利%季衛暘%李兵%汪璟
왕청%로효걸%전석%묘증리%계위양%리병%왕경
神经内镜%垂体腺瘤%经蝶入路%学习曲线
神經內鏡%垂體腺瘤%經蝶入路%學習麯線
신경내경%수체선류%경접입로%학습곡선
Endoscope%Pituitary adenoma%Endonasal transsphenoidal surgery%Learning curve
目的 通过比较神经内镜下经蝶入路切除垂体腺瘤不同阶段的手术效果,探讨神经内镜经蝶垂体腺瘤手术的学习曲线.方法 回顾性分析2002年9月至2006年12月由同一手术组连续完成的180例手术患者临床资料.按手术先后依次分为3组(A～C),每组60例设定为一手术阶段,比较各组手术时间、术中出血、中转显微手术率、肿瘤切除程度、术后视力改善情况、术后并发症及术后住院天数,分析不同阶段的手术效果.结果 各组病例在年龄、性别、肿瘤大小和病理分类等方面差异无统计学意义(P＞0.05)；在手术时间上A组和B、C组之间差异有统计学意义(P＜0.05),B和C组之间差异无统计学意义(P =0.921),A组手术时间明显长于其他各组(P＜0.05)；A组中转显微手术率较其他各组显著增加(P＜0.05)；术后严重并发症发生在B组(2例)、C组(1例)；各组术中出血、肿瘤切除程度、术后并发症及术后住院天数比较,差异均无统计学意义(P＞0.05).结论 神经内镜下经鼻蝶垂体腺瘤切除术经过60例左右手术可达到较熟练和稳定的程度.
目的 通過比較神經內鏡下經蝶入路切除垂體腺瘤不同階段的手術效果,探討神經內鏡經蝶垂體腺瘤手術的學習麯線.方法 迴顧性分析2002年9月至2006年12月由同一手術組連續完成的180例手術患者臨床資料.按手術先後依次分為3組(A～C),每組60例設定為一手術階段,比較各組手術時間、術中齣血、中轉顯微手術率、腫瘤切除程度、術後視力改善情況、術後併髮癥及術後住院天數,分析不同階段的手術效果.結果 各組病例在年齡、性彆、腫瘤大小和病理分類等方麵差異無統計學意義(P＞0.05)；在手術時間上A組和B、C組之間差異有統計學意義(P＜0.05),B和C組之間差異無統計學意義(P =0.921),A組手術時間明顯長于其他各組(P＜0.05)；A組中轉顯微手術率較其他各組顯著增加(P＜0.05)；術後嚴重併髮癥髮生在B組(2例)、C組(1例)；各組術中齣血、腫瘤切除程度、術後併髮癥及術後住院天數比較,差異均無統計學意義(P＞0.05).結論 神經內鏡下經鼻蝶垂體腺瘤切除術經過60例左右手術可達到較熟練和穩定的程度.
목적 통과비교신경내경하경접입로절제수체선류불동계단적수술효과,탐토신경내경경접수체선류수술적학습곡선.방법 회고성분석2002년9월지2006년12월유동일수술조련속완성적180례수술환자림상자료.안수술선후의차분위3조(A～C),매조60례설정위일수술계단,비교각조수술시간、술중출혈、중전현미수술솔、종류절제정도、술후시력개선정황、술후병발증급술후주원천수,분석불동계단적수술효과.결과 각조병례재년령、성별、종류대소화병리분류등방면차이무통계학의의(P＞0.05)；재수술시간상A조화B、C조지간차이유통계학의의(P＜0.05),B화C조지간차이무통계학의의(P =0.921),A조수술시간명현장우기타각조(P＜0.05)；A조중전현미수술솔교기타각조현저증가(P＜0.05)；술후엄중병발증발생재B조(2례)、C조(1례)；각조술중출혈、종류절제정도、술후병발증급술후주원천수비교,차이균무통계학의의(P＞0.05).결론 신경내경하경비접수체선류절제술경과60례좌우수술가체도교숙련화은정적정도.
Objective To investigate the learning curve of endoscopic transsphenoidal pituitary surgery by comparing the effects of endoscopic transsphenoidal pituitary surgery at different stages.Methods From September 2002 to December 2006,180 patients undergoing endoscopic transsphenoidal pituitary surgery,performed by a single team,were retrospectively evaluated.The patients were divided into groups A to C (n =60) based on the surgery data; operation time,intraoperation blood loss,conversion to microsurgery,total removal,improvement of postoperative vision,complications,and postoperative hospital stay were compared Results No statistical differences were found among the group in age,gender,turnor size,and pathological type; the significant differences were found in the operation time between group A,B,andC (P ＜0.05),but the operation time in group A was significantly longer than that in groups B and C (P ＜0.05).Compared with that in group A,the number of conversion to microsurgery decreased significantly in groups B and C.2 patients in group B and another in group C developed severe postoperative complications.The intraoperation blood loss,total removal,postoperative vision,complications,and postoperative hospital stay showed no differences amongst the three groups.Conclusions Endoscopic transsphenoidal pituitary surgery needs a minimum case-load of 60 patients to help go beyond the steep phase of the learning curve.
