[1]何　阳.神经内镜下经不同入路手术治疗垂体腺瘤的效果及对鼻腔功能的影响[J].中国临床神经外科杂志,2019,(09):540-542.[doi:10.13798/j.issn.1009-153X.2019.09.009]
　HE Yang.Outcomes of endoscopic transnasal minimally invasive surgery through different approaches for pituitary tumors and their effects on nasal function[J].,2019,(09):540-542.[doi:10.13798/j.issn.1009-153X.2019.09.009]
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神经内镜下经不同入路手术治疗垂体腺瘤的效果及对鼻腔功能的影响()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2019年09期
页码:
540-542
栏目:
论著
出版日期:
2019-09-20

文章信息/Info

Title:
Outcomes of endoscopic transnasal minimally invasive surgery through different approaches for pituitary tumors and their effects on nasal function
文章编号:
1009-153X（2019）09-0540-03
作者:
何　阳
471000 河南洛阳，河南科技大学第二附属医院神经外科（何　阳）
Author(s):
HE Yang
Department of Neurosurgery, The Second Affiliated Hospital, Henan University of Science and Technology, Luoyang 471000, China
关键词:
垂体腺瘤; 神经内镜; 经鼻中隔黏膜下蝶窦入路; 经鼻腔-蝶窦入路; 鼻腔功能
Keywords:
Pituitary adenomas;  Endoscopic surgery;  Transnasal submucosal sphenoid sinus approach;  Transnasal-sphenoidal approach;  Nasal function
分类号:
R 739.41; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2019.09.009
文献标志码:
A
摘要:
目的 探讨神经内镜下不同入路手术治疗垂体腺瘤的效果及对鼻腔功能的影响。方法 回顾性分析2014年10月至2017年9月神经内镜下手术治疗的120例垂体腺瘤的临床资料，其中经鼻中隔黏膜下蝶窦入路手术42例（鼻中隔组），经鼻腔-蝶窦入路手术78（鼻腔组）。比较术前及术后1、3、6个月通气功能[鼻气道阻力（NAR）]、嗅觉[识别阈（RT）]、生活质量[鼻腔鼻窦结局测试-20（SNOT-20）]变化，分析两组围术期基本情况、治疗效果及并发症。结果 术后1、3、6个月，两组NAR、RT、SNOT-20水平均较术前有显著提升（P<0.05），但鼻中隔组明显低于鼻腔组（P<0.05）。术后6个月，鼻中隔组有效率（83.33%）与鼻腔组（89.74%）无统计学差异（P>0.05）。鼻中隔组术后并发症总发生率（9.52%，4/42）明显低于鼻腔组（25.64%，20/78；P<0.05）。结论 与经鼻腔-蝶窦入路相比，经鼻中隔黏膜下蝶窦入路神经内镜下手术治疗垂体腺瘤对鼻腔功能影响更小且安全性更高。
Abstract:
Objective To explore the clinical effects of endoscopic surgery through different approaches on the pituitary tumors. Methods The clinical data of 120 patients with pituitary tumors, of whom, 42 (nasal septum group) underwent endoscopic surgery through transnasal submucosal sphenoid sinus approach and 78 (nasal cavity group) through transnasal-sphenoidal approach were analyzed retrospectively. The ventilation function [nasal airway resistance (NAR)], olfaction [recognition threshold (RT)], quality of life [sino-nasal outcome test-20 (SNOT-20)] were determined before the operation and 1, 3 and 6 months before the operation. The treatment effects and complications were analyzed and compared between the two groups 1, 3 and 6 months after the operation. Results The levels of NAR, five taste olfactory liquid RT and SNOT-20 were significantly higher 1, 3 and 6 months after the operation than those before the operation in the two groups (P<0.05), and they were significantly lower in the nasal septum group than those in the nasal cavity group 1, 3 and 6 months after the operation (P<0.05). The basic perioperative indexes including the intraoperative bleeding volume, operative duration, rate of nasal concha fracture and postoperative hospital stay were significantly lower in the nasal septum group than those in the nasal cavity group (P<0.05). There was insignificant difference in the treatment effects between the two groups (P>0.05). The total incidence of the complications was significantly lower in the nasal septum group than that in the nasal cavity group (P<0.05). Conclusions The endoscope surgery through transnasal submucosal sphenoid sinus approach has less impact on nasal function and has higher safety compared to the surgery through transnasnal-sphenoidal approach, and it is worth clinical application.

参考文献/References:

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备注/Memo

备注/Memo:
（2019-05-21收稿，2019-06-17修回）
更新日期/Last Update: 2019-09-20