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徐州医科大学附属医院神经外科,江苏,徐州,221000
纸质出版日期:2019,
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蒋昊, 范月超, 苗发安, 等. 神经内镜下经鼻蝶治疗不同类型垂体瘤的临床疗效分析[J]. 局解手术学杂志, 2019,(1).
JIANG Hao, FAN Yue-chao, MIAO Fa-an, et al. Clinical efficacy of transsphenoidal approach under neuroendoscopy in treatment of different types of pituitary tumors[J]. null, 2019,(1).
目的 比较不同类型垂体瘤患者神经内镜下经鼻蝶手术治疗的临床疗效,探讨垂体瘤患者神经内镜手术的最佳适应证。方法 选取2016年6月至2017年10月于徐州医科大学附属医院行神经内镜下经鼻蝶手术方式治疗的92例不同类型垂体瘤患者,通过对其术后激素水平是否正常、肿瘤是否全切进行对比评估不同类型垂体瘤患者的手术治疗效果。对患者进行追踪随访,使用健康测量量表(SF-36)评估患者生理机能(PF)、生理职能(RP)、情感职能(RE),评估不同类型垂体瘤患者的术后生活质量。结果 神经内镜在治疗不同类型垂体瘤方面的临床疗效存在差异,其从高到低的治愈率依次是皮质激素腺瘤、生长激素腺瘤、泌乳素腺瘤、混合型腺瘤、无功能腺瘤,功能型垂体瘤的治愈率明显高于无功能型垂体瘤,差异具有统计学意义(P<0.05)。功能型垂体瘤患者术后6个月随访时的PF得分(76.80±8.70)分,RP得分(78.37±19.10)分,RE得分(71.60±21.54)分;术后12个月随访时PF得分(87.30±9.33)分,RP得分(78.73±15.20)分,RE得分(87.86±17.75)分,均高于无功能型垂体腺瘤患者,差异均具有统计学意(P<0.05)。结论 功能型垂体瘤患者接受神经内镜手术治疗,以皮质激素腺瘤的治疗效果最好,并且可以显著提高术后患者的生活质量。
Objective To explore the best indication of neuroendoscopic surgery in patients with pituitary tumors by comparing the clinical effects of neuroendoscopic transsphenoidal surgery on patients with different types of pituitary tumors.Methods A total of 92 patients with different types of pituitary adenoma received transsphenoidal approach under neuroendoscopy in our hospital from June 2016 to October 2017 were selected
the surgical results were evaluated by comparing the postoperative hormone levels were normal or not and the tumor were resected or not.The patients were followed up
the physiological function (PF)
physiological function (RP)
emotional functions (RE) was determined by health measurement scale (SF-36) to evaluated the quality of life of patients.Results There were differences in clinical efficacy of neuroendoscopy for the treatment of different types of pituitary adenoma
the cure rate from high to low in turn was cortical hormone adenomas
growth hormone adenomas
prolactin adenomas
mixed adenoma
nonfunctional adenomas
the cure rate of functional pituitary adenoma was obviously higher than that of no functional pituitary adenoma
the difference was statistically significant(P<0.05).At 6 months after surgery
SF-36 result showed that PF scores was (76.30±8.68)
RP scores was (78.37±19.05)
RE scores was (71.54±21.54)
and at 12 months after surgery
PF scores was (87.20±9.24)
RP scores was (78.66±15.18) and RE scores was (87.80±17.67)
which were higher in patients with functional pituitary adenoma than those in patients with nonfunctional pituitary adenoma
the differences were significant(P<0.05).Conclusion The treatment of functional pituitary tumor by neuroendoscopic surgery
especially corticosteroid adenoma
has the best effect
and can significantly improve the quality of life of patients.
垂体瘤神经内镜经鼻蝶入路显微手术生活质量
pituitary adenomaneuroendoscopytranssphenoidal approachmicrosurgeryquality of life
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