①汕头大学医学院 广东 汕头 515041②惠州市中心人民医院经鼻蝶神经内镜垂体瘤切除术治疗垂体瘤患者的效果黄小山①② 罗洪海② 秦梓良② 陈建生②【摘要】 目的：分析经鼻蝶神经内镜垂体瘤切除术治疗垂体瘤患者的效果。
方法：选取2018年8月—2020年8月惠州市中心人民医院神经外科收治的88例垂体瘤患者。
随机将其分为显微镜组（44例）和经鼻蝶神经内镜组（44例）。
显微镜组采用显微镜垂体瘤切除术治疗，经鼻蝶神经内镜组采用经鼻蝶神经内镜垂体瘤切除术治疗。
比较两组围手术期指标，术前和术后2周激素水平、视觉恢复情况及并发症。
结果：经鼻蝶神经内镜组手术时间、住院时间、卧床时间均短于显微镜组，术中出血量少于显微镜组，差异有统计学意义（P <0.05）。
术后2周，经鼻蝶神经内镜组生长激素（GH）、催乳素（PRL）、促肾上腺皮质激素（ACTH）水平均低于显微镜组，差异有统计学意义（P <0.05）。
术后2周，经鼻蝶神经内镜组视野指数（VFI）高于显微镜组，经鼻蝶神经内镜组视野平均缺损（MD）、模式标准差（PSD）均低于显微镜组，差异有统计学意义（P <0.05）。
住院期间，经鼻蝶神经内镜组并发症发生率低于显微镜组，差异有统计学意义（P <0.05）。
结论：经鼻蝶神经内镜垂体瘤切除术治疗垂体瘤可有效缩短手术时间，减少术中出血量，促进患者术后恢复，同时调节激素水平，促进视觉恢复，并降低术后并发症的发生率，安全性较好。
【关键词】 垂体瘤 经鼻蝶神经内镜 垂体瘤切除术 激素 视觉 doi：10.14033/ki.cfmr.2023.14.034 文献标识码 B 文章编号 1674-6805（2023）14-0135-04 Effects of Transsphenoidal Neuroendoscopy Pituitary Tumor Resection in the Treatment of Patients with Pituitary Tumor/HUANG Xiaoshan, LUO Honghai, QIN Ziliang, CHEN Jiansheng. //Chinese and Foreign Medical Research, 2023, 21(14): 135-138 [Abstract] Objective: To analyze the effects of transsphenoidal neuroendoscopy pituitary tumor resection in the treatment of patients with pituitary tumor. Method: A total of 88 patients with pituitary tumors admitted to Department of Neurosurgery of Huizhou Central People's Hospital from August 2018 to August 2020 were selected. They were randomly divided into microscope group (44 cases) and transsphenoidal neuroendoscopy group (44 cases). The microscope group was treated with microscopic pituitary tumor resection, and the transsphenoidal neuroendoscopy group was treated with transsphenoidal neuroendoscopy pituitary tumor resection. The perioperative indicators, hormone levels, visual recovery condition before and 2 weeks after operation and complications were compared between the two groups. Result: The operation time, hospitalization time and bed time of the transsphenoidal neuroendoscopy group were shorter than those of the microscope group, and the intraoperative blood loss volume was less than that of the microscope group, and the differences were statistically significant (P <0.05). At 2 weeks after operation, the levels of growth hormone (GH), prolactin (PRL) and adrenocorticotropic hormone (ACTH) in the transsphenoidal neuroendoscopy group were lower than those in the microscope group, and the differences were statistically significant (P <0.05). At 2 weeks after operation, the visual field index (VFI) of the transsphenoidal neuroendoscopy group was higher than that of the microscope group, and the visual field mean defect (MD) and pattern standard deviation (PSD) of the transsphenoidal neuroendoscopy group were lower than those of the microscope group, and the differences were statistically significant (P <0.05). During hospitalization, the incidence of complications in the transsphenoidal neuroendoscopy group was lower than that in the microscope group, and the difference was statistically significant (P <0.05). Conclusion: Transsphenoidal neuroendoscopy pituitary tumor resection for the treatment of pituitary tumors can effectively shorten the operation time, reduce intraoperative blood loss volume, promote postoperative recovery of patients, regulate hormone levels, promote visual recovery, and reduce the incidence of postoperative complications, with good safety. [Key words] Pituitary tumors Transsphenoidal neuroendoscopy Pituitary tumor resection Hormone Visual First-author's address: Shantou University Medical College, Shantou 515041, China 垂体瘤是神经外科常见神经内分泌腺体肿瘤疾病，患者临床主要表现为头痛、内分泌紊乱、视野障碍等[1]。
