摘要【目的】探讨经鼻内窥镜垂体瘤切除术对垂体瘤患者应激因子水平的影响。【方法】回顾性分析2016年8月至2019年6月本院收治的62例垂体瘤患者的临床资料,根据手术方法不同将其分为观察组(鼻内窥镜下单鼻孔蝶窦入路垂体瘤切除术)和对照组(显微镜下经鼻蝶入路垂体瘤切除术),每组各31例。分析两组患者治疗后的疗效及术后应激因子、并发症率情况。【结果】观察组手术时间、术后住院时间短于对照组,术中出血量、肿瘤全切比例低于对照组,差异有统计学意义( P <0.05)。术后3 d,两组患者血清超敏C反应蛋白(hs-CRP)、白介素-8(IL-8)、生长激素(GH)、泌乳素(PRL)、促肾上腺皮质激素(ACTH)水平均高于术前,观察组低于对照组,差异均有统计学意义( P <0.05)。观察组术后并发症发生率低于对照组,差异有统计学意义( χ2 =4.769, P =0.029<0.05)。【结论】经鼻内窥镜垂体瘤切除术应用于垂体瘤患者创伤小,出血量少,对机体应激反应小,有利于改善内分泌因子,且安全性高。
Abstract：【Objective】To investigate the effect of endoscopic pituitary tumor resection on stress factors in patients with pituitary tumor.【Methods】 The clinical data of 62 patients with pituitary adenomas admitted to our hospital from August 2016 to June 2019 were retrospectively analyzed. According to different surgical methods, they were divided into observation group (single nostril transsphenoidal approach pituitary adenoma resection under nasal endoscope) and control group (transsphenoidal approach pituitary adenoma resection under microscope), 31 cases in each group. The curative effect, postoperative stress factors and complication rate of the two groups were analyzed. 【Results】The operation time and postoperative hospital stay of the observation group were shorter than those of the control group, the intraoperative blood loss and the proportion of total tumor resection of the observation group were lower than those of the control group, the difference was statistically significant ( P <0.05). Three days after operation, the levels of serum high sensitivity C-reactive protein (hs CRP), interleukin-8 (IL-8), growth hormone (GH), prolactin (PRL) and adrenocorticotropic hormone (ACTH) in the two groups were higher than those before operation, and those in the observation group were lower than those in the control group ( P <0.05). The incidence of postoperative complications in the observation group was significantly lower than that in the control group ( χ2 =0.029, P =0.05).【Conclusion】Transnasal endoscopic pituitary adenoma resection has the advantages of less trauma, less blood loss and less stress response to the body, which is conducive to improving endocrine factors and has high safety.
2021, Vol. 38 
