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神经内镜与神经导航辅助显微镜下经鼻蝶垂体瘤切除术后视觉、嗅觉功能和激素水平对比分析 预览

Comparison of transspheniodal ectomy of hypophysoma by neuroendoscope and neuronavigation-assisted on vision,olfactory function and hormone levels
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摘要 目的通过对比术后视觉、嗅觉功能和激素水平的差异,探讨神经内镜与神经导航辅助显微镜下经鼻蝶垂体瘤切除术的临床疗效。方法选择2014年4月至2017年10月我院收治的84例垂体腺瘤患者作为研究对象,按照随机数字法分为A组(41例)和B组(43例),2组患者垂体瘤切除均经鼻蝶入路,A组使用神经内镜,B组为神经导航辅助显微镜,术后随访3周,对比2组方案的视觉功能、嗅觉功能和相关激素水平。结果 2组患者治疗前的视觉功能指标包括视野平均缺损(MD)、模式标准差(PSD)及视野指数(VFI)水平差异无统计学意义(P〉 0. 05);术后3周,2组患者的MD、PSD与术前比较均显著降低,VFI值显著增高,差异具有统计学意义(P 〈0. 05),术后组间比较,差异无统计学意义(P〉 0. 05)。2组患者的嗅觉识别阈值治疗前差异无统计学意义(P〉 0. 05);术后3周,2组患者的嗅觉识别阈值与术前比较均显著增高(P 〈0. 05),且B组显著高于A组,组间比较差异有统计学意义(P 〈0. 05)。2组患者治疗前,催乳素(PRL)、生长激素(GH)及促肾上腺皮质激素(ACTH)水平差异无统计学意义(P〉 0. 05);术后3周,2组患者的激素水平与术前比较均显著降低(P 〈0. 05),组间比较差异无统计学意义(P〉 0. 05)。结论两种经鼻蝶入路垂体瘤切除术方案在恢复患者术后视觉功能和激素水平上都表现出良好的效果,神经内镜的术式更有利于嗅觉功能的早期恢复。 Objective To investigate the clinical effect of transspheniodal ectomy of hypophysoma under neuroendoscope and neuronavigation assisted microscope,the difference of vision,olfactory function and hormonal levels after operation was compared. Methods A total of84 patients with pituitary adenoma admitted from April 2014 to October 2017 were selected as the subjects and divided into group A(41 cases) and group B(43 cases) according to the random number rule. The pituitary tumor resection was performed in the two groups via sphenoid approach. Group A used a neuroendoscope,group B used a neuronavigation assisted microscope. The postoperative follow-up was 3 weeks. The visual function,olfactory function,and related hormone levels of the two groups were compared. Results Before the treatment,there was no significant difference in the visual function indexes included the average visual field defect(MD),the standard deviation(PSD)and the visual field index(VFI) between two groups(P 〉 0. 05). In the 3 weeks after the operation,the MD and PSD of the two groups were significantly reduced,while VFI was significantly increased,the differences were significant(P 〈 0. 05),while no statistically significant difference was found between two groups after surgery(P 〉 0. 05). There was no significant difference in olfactory threshold between the two groups before surgery(P 〉 0. 05). In 3 weeks after surgery,the olfactory sense of smell in both groups were better than that before surgery(P 〈 0. 05),futhermore,the group B was better than group A(P 〈 0. 05). There was no significant difference in levels of PRL,growth hormone(GH) and adrenocorticotrophic hormone(ACTH) in both groups before surgery(P 〉 0. 05); 3 weeks after surgery,the hormonal levels of both groups were decreased than that before(P 〈 0. 05),and no significant difference was found between two groups(P 〉 0. 05). Conclusion The transspheniodal ectomy of hypophysoma via both two approaches can a
作者 李勐 林大为 于德安 高晓红 回鹏 高石 LI Meng 1,LIN Da-wei 1,YU De-an 1,GAO Xiao-hong 2,HUI Peng 1,GAO Shi1(1.Department of Neurosurgery,Fushun Hospital of TCM,Fushun Liaoning 113008,China;2.Department of Neurology,Fushun Hospital of TCM,Fushun Liaoning 113008,China)
出处 《局解手术学杂志》 2018年第11期818-821,共4页 Journal of Regional Anatomy and Operative Surgery
关键词 神经内镜 神经导航辅助显微镜 垂体瘤切除术 视觉功能 嗅觉功能 激素水平 垂体瘤 neuroendoscopy neuronavigation assisted microscope pituitary tumor resection visual function olfactory function hormonal level hypophysoma
作者简介 [通信作者]李勐,E-mail:tjrenkai@126.com
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