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时间:2020-03-21
《多技术辅助神经内镜下侵袭海绵窦的垂体腺瘤的治疗.pdf》由会员上传分享,免费在线阅读,更多相关内容在工程资料-天天文库。
1、中国医学科学院学报ACTAACADEMIAEMEDICINAESINICAE·论著·多技术辅助神经内镜下侵袭海绵窦的垂体腺瘤的治疗位振清,王任直,姚勇,邓侃,王剑新,刘小海,代从新中国医学科学院北京协和医学院北京协和医院神经外科,北京100730通信作者:王任直电话:010-69152530,电子邮件:wangrz@126.COB摘要:目的探讨多技术辅助神经内镜下侵袭海绵窦的巨大垂体腺瘤的手术疗效。方法对比分析同期72例神经内镜下和55例显微镜下侵袭海绵窦的巨大垂体腺瘤的手术疗效,两组均采用扩大经蝶人路,术中应用神经导航和多普勒,并对两组临床资料进行统计学分析。结果神经内镜组与显微镜
2、组在肿瘤全切率、手术时间、术后鼻腔通畅率和术后复发率方面差异具有统计学意义(P=0.004,P=0.0003,P=0.000,P=0.002);在脑脊液漏、术后尿崩、颅神经损伤等方面差异无统计学意义(P>0.05)。结论多技术辅助神经内镜下扩大经蝶入路是治疗侵袭海绵窦的巨大垂体腺瘤的首选手术方法,外侧海绵窦人路和分子生物学研究为侵袭性垂体腺瘤的治疗提供了更为广阔的前景。关键词:神经内镜;扩大经蝶人路;海绵窦中图分类号:R651.1+3文献标志码:A文章编号:1000—503X(2014)02—0189—05DOI:10.3881/j.issn.1O00—503X.2014.02.01
3、4TreatmentofPituitaryAdenomasInvadingCavernousSinuswithNeurOend0scOpyAssistedbyMultipleTechniquesWEIZhen·qing,WANGRen—zhi,YAOYong,DENGKan,WANGJian—xin,LIUXiao—hai,DAICong—xinDepartmentofNeurosurgery,PUMCHospital,CAMSandPUMC,Beijing100730,ChinaCorrespondingauthor:WANGRen-zhiTel:010-69152530,E-ma
4、il:wangrz@126.comABSTRACT:0bjectiveTostudytheeffectivenessoftreatinggiantpituitaryadenomasinvadingcaver-lqOUSsinuswithneuroendoscopyassistedbymultipletechniques.MethodsAtotalof72patientswhounderwentneuroendoscopicsurgeryand55patientswhounderwentmicroscopicsurgeryforgiantpituitaryadenomaswereen-
5、rolledinthisretrospectiveanalysis.Bothgroupsreceivedexpandedendoscopicendonasaltranssphenoidal印一proach,intraoperativeapplicationofnavigation,andDoppler.Theclinicaldataoftwogroupswerecompared.ResultsThetwogroupsweresignificantlydifferentintotaltumorremovalrate,operationtime,postoperativenasalpat
6、ency,andpostoperativerecurrencerate(P=0.004,P=0.0003,P=0.000,andP=0.002,re—spectively),whereasthecerebrospinalfluidleakage,postoperativediabetesinsipidus,andcranialnerveinjurywerenotsignificantlydifferent(P>0.05).ConclusionsExpandedneuroendoscopicendonasaltranssphenoi—dalapproachassistedbymulti
7、pletechniquesisthepreferredsurgicalmethodforgiantinvasivepituitaryadenomasinvadingcavernoussinus.Thelateralcavernoussinusapproachandthefurthermolecularbiologyresearchwill基金项目:首都卫生发展基金(首发2011-4001—06)SupportedbytheCapitalHealthDeve
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