单鼻腔经蝶内窥镜垂体瘤手术与经口鼻蝶窦垂体瘤手术的比较研究.doc

1 单鼻腔经蝶内窥镜垂体瘤手术与经口鼻蝶窦垂体瘤手术的比较研究作者:胡卫星李立新傅震乔明哲顾培元吴幼章【关键词】垂体腺瘤【摘要】目的总结比较单侧鼻腔经蝶内窥镜垂体瘤手术和经口鼻蝶窦垂体瘤手术的临床疗效及特点。方法前瞻设计, 将近两年 75 例垂体瘤病例以 2∶3 随机分为单鼻腔经蝶内窥镜手术( Ⅰ组 29 例)和经口鼻蝶窦手术( Ⅱ组46 例) 两组, 进行比较研究。结果(1) 术前两组病例临床资料无明显差异, P 值均 。(2 )肿瘤切除率:Ⅰ组 27/29; Ⅱ组 39/46 。(3 )出血情况: 术中平均输血量:Ⅰ组 50ml/ Ⅱ组 200ml ( ) 。术后 48h 内鼻部敷料平均更换次数Ⅰ组0 次/Ⅱ组3次。(4 )其它:①术中误伤鞍隔脑脊液漏Ⅰ组1例/ Ⅱ组5 例。②术后尿崩Ⅰ组3例/Ⅱ组 14 例。③术后内分泌功能恢复者Ⅰ组 11 例( 11/19 ),Ⅱ组 10 例( 10/32 )。④术后鼻外形改变Ⅰ组0例/Ⅱ组 31例, 鼻纵隔穿孔Ⅰ组0例/Ⅱ组3例, 蝶窦囊肿Ⅰ组0例/Ⅱ组2例。⑤术后平均住院Ⅰ组 5天/Ⅱ组 。两组病例均无手术死亡和感染病例。结论单 2 鼻腔经蝶内窥镜手术深部照明清楚, 无盲区, 肿瘤切除彻底; 具有疗效高、创伤小、恢复快、并发症少等优点, 值得进一步推广。关键词垂体腺瘤内窥镜手术入路微创【 Abstract 】 Objective To evaluate endoscopic monoendonasal transsphenoidal pituitary tumor ˉ paring with sublabial transsphenoidal approach. Methods Consecutive75cases of pituitary tumors were prospectively divided into two groups ( group Ⅰ 29/group Ⅱ 46) at2:ording to randomly design. The clinical results and char ˉ acteristics pared between two were no significant differences of preoperation clini ˉ cal data in two groups ( ) . of tumor resection were27/29 (Ⅰ) and39/46 (Ⅱ) situation:The mean volumes of transfusion were50ml (Ⅰ) /200ml during of nose-dress ˉ ing refreshing were0 (Ⅰ) /3(Ⅱ) in the first 48 hrs : ① Unexpected Diaphragma sellae damage and temporal CSF leakage were1 (Ⅰ) /5(Ⅱ).② Pituitary