中华脑科疾病与康复杂志(电子版)
中華腦科疾病與康複雜誌(電子版)
중화뇌과질병여강복잡지(전자판)
CHINESE JOURNAL OF BRAIN DI8SEASES AND REHABILITATIN(ELECTRONIC EDITION)
2014年
6期
31-35
,共5页
刘宇利%郑勇%成振林%王继超%吴永刚%张诚%高峰
劉宇利%鄭勇%成振林%王繼超%吳永剛%張誠%高峰
류우리%정용%성진림%왕계초%오영강%장성%고봉
内窥镜检查%显微镜检查%垂体腺瘤
內窺鏡檢查%顯微鏡檢查%垂體腺瘤
내규경검사%현미경검사%수체선류
Endoscopy%Microscopy%Pituitay adenoma
目的:比较神经内镜与显微镜下经单鼻孔蝶窦入路切除垂体腺瘤的疗效。方法回顾性分析2007年7月至2008年7月40例神经内镜下(神经内镜组)和24例显微镜下(显微镜组)经鼻蝶窦入路垂体瘤切除患者的临床资料,对比两组患者手术疗效。计量资料采用t检验或秩和检验,计数资料采用χ2检验或秩和检验。结果神经内镜组肿瘤全切率为92.5%,显微镜组全切除率为83.3%,两组差异不具有统计学意义(χ2=0.524,P=0.469)。神经内镜组手术时间2.1(0.50)h,显微镜组2.6(1.15)h,两组差异不具有统计学意义(Z=-1.848,P=0.065);术中出血量[20.0(5.00)ml]少于显微镜组[25.5(12.25)ml,Z=-3.757,P=0.000];住院时间[(8.75±2.753)d]显著短于显微镜组[(15.13±3.069)d,t=-8.591,P=0.000]。神经内镜组发生尿崩2例、电解质紊乱4例,显微镜组发生尿崩2例、脑脊液漏2例、高热1例、电解质紊乱4例、鼻中隔缺损6例,除鼻中隔缺损(χ2=8.288,P=0.004)差异有统计学意义外,其他并发症发生率差异无统计学意义( P 均>0.05)。结论神经内镜和显微镜下单鼻孔经蝶入路垂体瘤切除术疗效满意,安全性高。其中内镜治疗在术中出血量、住院时间、并发症方面更具优势,是今后神经外科手术的发展方向。
目的:比較神經內鏡與顯微鏡下經單鼻孔蝶竇入路切除垂體腺瘤的療效。方法迴顧性分析2007年7月至2008年7月40例神經內鏡下(神經內鏡組)和24例顯微鏡下(顯微鏡組)經鼻蝶竇入路垂體瘤切除患者的臨床資料,對比兩組患者手術療效。計量資料採用t檢驗或秩和檢驗,計數資料採用χ2檢驗或秩和檢驗。結果神經內鏡組腫瘤全切率為92.5%,顯微鏡組全切除率為83.3%,兩組差異不具有統計學意義(χ2=0.524,P=0.469)。神經內鏡組手術時間2.1(0.50)h,顯微鏡組2.6(1.15)h,兩組差異不具有統計學意義(Z=-1.848,P=0.065);術中齣血量[20.0(5.00)ml]少于顯微鏡組[25.5(12.25)ml,Z=-3.757,P=0.000];住院時間[(8.75±2.753)d]顯著短于顯微鏡組[(15.13±3.069)d,t=-8.591,P=0.000]。神經內鏡組髮生尿崩2例、電解質紊亂4例,顯微鏡組髮生尿崩2例、腦脊液漏2例、高熱1例、電解質紊亂4例、鼻中隔缺損6例,除鼻中隔缺損(χ2=8.288,P=0.004)差異有統計學意義外,其他併髮癥髮生率差異無統計學意義( P 均>0.05)。結論神經內鏡和顯微鏡下單鼻孔經蝶入路垂體瘤切除術療效滿意,安全性高。其中內鏡治療在術中齣血量、住院時間、併髮癥方麵更具優勢,是今後神經外科手術的髮展方嚮。
목적:비교신경내경여현미경하경단비공접두입로절제수체선류적료효。방법회고성분석2007년7월지2008년7월40례신경내경하(신경내경조)화24례현미경하(현미경조)경비접두입로수체류절제환자적림상자료,대비량조환자수술료효。계량자료채용t검험혹질화검험,계수자료채용χ2검험혹질화검험。결과신경내경조종류전절솔위92.5%,현미경조전절제솔위83.3%,량조차이불구유통계학의의(χ2=0.524,P=0.469)。신경내경조수술시간2.1(0.50)h,현미경조2.6(1.15)h,량조차이불구유통계학의의(Z=-1.848,P=0.065);술중출혈량[20.0(5.00)ml]소우현미경조[25.5(12.25)ml,Z=-3.757,P=0.000];주원시간[(8.75±2.753)d]현저단우현미경조[(15.13±3.069)d,t=-8.591,P=0.000]。신경내경조발생뇨붕2례、전해질문란4례,현미경조발생뇨붕2례、뇌척액루2례、고열1례、전해질문란4례、비중격결손6례,제비중격결손(χ2=8.288,P=0.004)차이유통계학의의외,기타병발증발생솔차이무통계학의의( P 균>0.05)。결론신경내경화현미경하단비공경접입로수체류절제술료효만의,안전성고。기중내경치료재술중출혈량、주원시간、병발증방면경구우세,시금후신경외과수술적발전방향。
Objective To compare the curative effect of resection of pituitary adenoma by endoscope and microscope single nostril transsphenoidal approach.Me thods From July 2007 to July 2008 ,40 cases of endoscopic ( endoscopic group ) and 24 cases of microscope ( microscopy group ) by transsphenoidal removal of pituitary adenomas patients with clinical data were retrospectively analyzed ,the operation curative effect were compared.t test, rank sum test or χ2 were used to compare the differences between the two groups . Results Total resection rate in endoscopic group was 92.5%,while in microscopy group total was 83.3%, there was no statistical difference between the two groups (χ2 =0.524 , P =0.469 ) .Operation time in endoscopy group was 2.1 ( 0.50 ) h, while in microscopy group was 2.6 ( 1.15 ) h, there was no statistical difference between the two groups (Z=-1.848,P=0.065).The amount of bleeding in endoscopy group [20.0(5.00)ml]was less than that in microscopy group [25.5(12.25)ml,Z=-3.757,P=0.000];Hospitalization time in endoscopy group [(8.75 ±2.753) d] was significantly shorter than the microscope group [(15.13 ±3.069)d,t =-8.591,P=0.000].In endoscopic group,there were 2 cases of diabetes insipidus,electrolyte disorder in 4 cases,in microscopy group,there were 2 cases of diabetes insipidus, leakage of cerebrospinal fluid in 2 cases,fever in 1 cases,electrolyte disorders in 4 cases,nasal septal defect in 6 cases.Except the nasal septum defect had significant difference between the two groups (χ2 =8.288,P=0.004 ) ,there was no significant difference in other complication rates ( P>0.05 ) .Conclusion Endoscope and microscope place an order nostril transsphenoidal approach for pituitary adenoma resection with curative effect and safety.The endoscopic treatment for bleeding , hospitalization time, complications have more advantages ,and it will be the development direction operation of the neurosurgery in the future .