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目的研究神经内镜辅助下经鼻蝶窦入路垂体瘤切除术的术中应激状况及疗效。方法选取2014年3月至2015年3月我院接诊的60例垂体瘤患者作为本次研究对象。观察组采取神经内镜辅助下经鼻蝶窦入路垂体瘤切除术进行治疗,对照组采取经口鼻下鼻中隔垂体瘤切除术进行治疗,观察两组患者术中应激反应情况、治疗相关指标、治疗后不良反应情况、治疗疗效情况。结果观察组肾上腺素(E)、去甲肾上腺素(NE)(98.30±12.11、103.42±15.03)ng/ml、肾素(R)、血管紧张素(ATⅡ)(2.33±0.52、28.12±5.51)pg/ml均小于对照组(160.15±19.08、188.72±20.58)ng/ml、(4.80±0.72、48.18±7.10)pg/ml差异具有统计学意义(P<0.05);观察组手术时间、术中出血量、术后住院时间均小于对照组,差异具有统计学意义(P<0.05);观察组不良反应总发生率10.00%(5/50)小于对照组44.00%(22/50),差异具有统计学意义(P<0.05);观察组激素下降程度、肿瘤残留、肿瘤体积减少程度均小于对照组,差异具有统计学意义(P<0.05)。结论神经内镜辅助下经鼻蝶窦入路垂体瘤切除术能够降低患者的术中应激水平,治疗疗效显著,能够有效的清除患者的肿瘤。
Objective To study the intraoperative stress and efficacy of neurosurgery assisted transsphenoidal approach for pituitary adenoma resection. Methods From March 2014 to March 2015, 60 cases of pituitary adenocarcinoma admitted to our hospital were selected as the study objects. The observation group was treated with neurosurgery assisted transsphenoidal sinus pituitary tumor resection, while the control group was treated by transnasal and nasal septum pituitary tumor resection. The intraoperative stress response and treatment-related indicators , Adverse reactions after treatment, the treatment effect. Results The levels of epinephrine (E), norepinephrine (NE) (98.30 ± 12.11,103.42 ± 15.03) ng / ml, renin and ATⅡ were 2.33 ± 0.52 and 28.12 ± 5.51 in observation group pg / ml in the observation group was significantly lower than that in the control group (160.15 ± 19.08, 188.72 ± 20.58) ng / ml, (4.80 ± 0.72, 48.18 ± 7.10) pg / Bleeding, postoperative hospital stay were less than the control group, the difference was statistically significant (P <0.05); the total incidence of adverse reactions in the observation group 10.00% (5/50) was less than the control group 44.00% (22/50), the difference was (P <0.05). The decrease of hormone, the residual tumor and the decrease of tumor volume in the observation group were all less than those in the control group (P <0.05). Conclusion Neuroendoscope assisted transsphenoidal approach for pituitary adenoma resection can reduce intraoperative stress in patients with significant therapeutic effect, which can effectively remove the patient’s tumor.