中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2015年
9期
882-887
,共6页
俞雷%鲁晓杰%王清%汪璟
俞雷%魯曉傑%王清%汪璟
유뢰%로효걸%왕청%왕경
垂体腺瘤%显微外科手术%神经内镜%荟萃分析
垂體腺瘤%顯微外科手術%神經內鏡%薈萃分析
수체선류%현미외과수술%신경내경%회췌분석
Pituitary adenoma%Microsurgery%Neuroendoscopy%Meta-analysis
目的 评价经鼻蝶窦显微镜下和神经内镜下垂体腺瘤切除术的临床疗效.方法 通过检索PubMed、Web of Science、Embase、Cochrane Library等数据库,搜集所有报道神经内镜和显微镜下手术治疗垂体腺瘤的随机对照试验或病例对照研究的英文文献,采用Review Manager 5.3软件对数据进行荟萃分析.结果 经过筛选共纳入22篇文献.研究对象共计1 987例患者,其中内镜组1 000例,显微镜组987例.全切除率方面,采用固定效应模型合并OR值为1.62(95％ CI:1.21,2.17,P=0.001);而在术后并发症方面,脑脊液漏、尿崩症、脑膜炎、鼻腔并发症两组差异均无统计学意义(均P ＞0.05).两组术后住院时间神经内镜组较显微镜组短(P＜0.05),而手术时间两组差异无统计学意义(P＞0.05).结论 根据目前已有的文献,经蝶窦神经内镜下垂体腺瘤切除术的全切除率要显著高于经鼻蝶窦显微手术.虽然在术后并发症、手术时间方面两者无明显差别,但在缩短术后住院时间方面神经内镜存在一定优势.
目的 評價經鼻蝶竇顯微鏡下和神經內鏡下垂體腺瘤切除術的臨床療效.方法 通過檢索PubMed、Web of Science、Embase、Cochrane Library等數據庫,搜集所有報道神經內鏡和顯微鏡下手術治療垂體腺瘤的隨機對照試驗或病例對照研究的英文文獻,採用Review Manager 5.3軟件對數據進行薈萃分析.結果 經過篩選共納入22篇文獻.研究對象共計1 987例患者,其中內鏡組1 000例,顯微鏡組987例.全切除率方麵,採用固定效應模型閤併OR值為1.62(95％ CI:1.21,2.17,P=0.001);而在術後併髮癥方麵,腦脊液漏、尿崩癥、腦膜炎、鼻腔併髮癥兩組差異均無統計學意義(均P ＞0.05).兩組術後住院時間神經內鏡組較顯微鏡組短(P＜0.05),而手術時間兩組差異無統計學意義(P＞0.05).結論 根據目前已有的文獻,經蝶竇神經內鏡下垂體腺瘤切除術的全切除率要顯著高于經鼻蝶竇顯微手術.雖然在術後併髮癥、手術時間方麵兩者無明顯差彆,但在縮短術後住院時間方麵神經內鏡存在一定優勢.
목적 평개경비접두현미경하화신경내경하수체선류절제술적림상료효.방법 통과검색PubMed、Web of Science、Embase、Cochrane Library등수거고,수집소유보도신경내경화현미경하수술치료수체선류적수궤대조시험혹병례대조연구적영문문헌,채용Review Manager 5.3연건대수거진행회췌분석.결과 경과사선공납입22편문헌.연구대상공계1 987례환자,기중내경조1 000례,현미경조987례.전절제솔방면,채용고정효응모형합병OR치위1.62(95％ CI:1.21,2.17,P=0.001);이재술후병발증방면,뇌척액루、뇨붕증、뇌막염、비강병발증량조차이균무통계학의의(균P ＞0.05).량조술후주원시간신경내경조교현미경조단(P＜0.05),이수술시간량조차이무통계학의의(P＞0.05).결론 근거목전이유적문헌,경접두신경내경하수체선류절제술적전절제솔요현저고우경비접두현미수술.수연재술후병발증、수술시간방면량자무명현차별,단재축단술후주원시간방면신경내경존재일정우세.
Objective To evaluate the clinical efficacy of transnaso-sphenoidal microsurgery and neuroendoscopic resection of pituitary adenoma.Methods All the English literature about the randomized controlled trials or case-control studies reporting neuroendoscopy and treatment of pituitary adenoma under the microscope were collected by searching the database,including PubMed,Web of Science,Embase,and the Cochrane Library.The data were used to conduct meta-analysis using Review Manager 5.3 software.Results A total of 22 literatures were enrolled after screening.A total of 1 987 patients were studied,including 1 000 in a neuroendoscope group and 987 in a microscope group.In terms of total resection rate,the combined odds ratio using the fixed effect model was 1.62 (95％ CI 1.21-2.17,P =0.001);and in terms of postoperative complications,there were no significant differences in cerebrospinal fluid leakage,diabetes insipidus,meningitis,nasal complications between the two groups (all P ＞0.05).The postoperative hospital stay of the neuroendoscope group was shorter than that of the microscope group (P ＜ 0.05),and there was no significant difference in operation time between the two groups (P ＞ 0.05).Conclusions According to the literature available,the total resection rate of neuroendoscopic transnaso-sphenoidal resection of pituitary adenoma was significantly higher than that of transnasal sphenoidal microsurgery.There was no significant difference between the postoperative complications and the operation time,but neuroendoscopy had some advantages for shortening the hospitalization time after procedure.
