發(fā)布時(shí)間：2018-03-28 06:09

  本文選題：神經(jīng)內(nèi)鏡　切入點(diǎn)：顯微鏡　出處：《浙江大學(xué)》2017年碩士論文

【摘要】：研究目的:比較顯微鏡和神經(jīng)內(nèi)鏡下經(jīng)鼻蝶垂體瘤切除術(shù)的優(yōu)劣。研究方法:選取我院(浙江大學(xué)醫(yī)學(xué)院附屬邵逸夫醫(yī)院神經(jīng)外科)同一醫(yī)療小組2008年1月-2016年12月期間顯微鏡下經(jīng)鼻蝶垂體瘤切除術(shù)病例63例作為顯微鏡組,神經(jīng)內(nèi)鏡下經(jīng)鼻蝶垂體瘤切除術(shù)病例85例作為內(nèi)鏡組。統(tǒng)計(jì)兩組病例的患者年齡、性別、腫瘤切除情況、手術(shù)時(shí)間、術(shù)后住院時(shí)間及術(shù)后并發(fā)癥(尿崩癥、腦脊液漏、感染、顱內(nèi)出血、鼻出血)等數(shù)據(jù),運(yùn)用SPSS軟件進(jìn)行分析,計(jì)量資料以均數(shù)±標(biāo)準(zhǔn)差(x±S)采用t檢驗(yàn);計(jì)數(shù)資料以率(%)表示,采用χ2檢驗(yàn),P0.05有統(tǒng)計(jì)學(xué)意義。結(jié)果:全切率神經(jīng)內(nèi)鏡組比顯微鏡組高(91.8%VS 76.2%),χ2=6.935,p=0.008,有顯著性差異;手術(shù)時(shí)間神經(jīng)內(nèi)鏡組比顯微鏡組短(113.18±36.38minVS 134.37±57.31min),t=2.575,p=0.012,有顯著性差異;術(shù)后住院時(shí)間神經(jīng)內(nèi)鏡組比顯微鏡組短(7.02±2.37天VS 8.00±2.78天),t=2.293,p=0.023,有顯著性差異;術(shù)后并發(fā)癥:腦脊液漏發(fā)生率神經(jīng)內(nèi)鏡組比顯微鏡組高(3.5%VS 1.6%),χ2=0.519,p=0.471,無(wú)顯著性差異;尿崩癥發(fā)生率神經(jīng)內(nèi)鏡組比顯微鏡組低(1.2%VS3.2%),χ2=0.727,p=0.394,無(wú)顯著性差異;感染發(fā)生率神經(jīng)內(nèi)鏡組比顯微鏡組低(1.2%VS1.6%),χ2=0.046,p=0.831,無(wú)顯著性差異;出血發(fā)生率神經(jīng)內(nèi)鏡組比顯微鏡組低(0%VS 1.6%);鼻出血發(fā)生率神經(jīng)內(nèi)鏡組比顯微鏡組高(9.4%VS 1.6%),χ2=3.879,p=0.049,有顯著性差異。結(jié)論:神經(jīng)內(nèi)鏡下經(jīng)鼻蝶垂體瘤切除術(shù)對(duì)比顯微鏡下經(jīng)鼻蝶垂體瘤切除術(shù),腫瘤全切率高,手術(shù)時(shí)間短,術(shù)后住院時(shí)間短,尿崩癥、感染、出血發(fā)生率低,但腦脊液漏、鼻出血發(fā)生率高�？傮w來(lái)說(shuō)神經(jīng)內(nèi)鏡下經(jīng)鼻蝶垂體瘤切除術(shù)優(yōu)于顯微鏡下經(jīng)鼻蝶垂體瘤切除術(shù)。
[Abstract]:Objective: to compare the advantages and disadvantages of transsphenoidal pituitary adenoma resection under microscope and endoscope. Methods: the same medical team was selected from January 2008 to 2016 in our hospital (run run run Shaw Hospital affiliated to Zhejiang University School of Medicine). A total of 63 patients underwent transsphenoidal pituitary adenoma resection under microscope for 12 months. Eighty-five patients with endoscopic transsphenoidal pituitary adenoma were treated as endoscopic group. Age, sex, tumor resection, operation time, postoperative hospital stay and postoperative complications (diabetes insipidus, cerebrospinal fluid leakage, infection) were analyzed. The data of intracranial hemorrhage and epistaxis were analyzed by SPSS software. The measurement data were measured by mean 鹵standard deviation (x 鹵S) using t test, and the counting data were expressed by rate. Results: the total removal rate of neuroendoscopy group was 91.8% higher than that of the microscope group (P < 0.05), and there was significant difference between the two groups, and the operative time was 113.18 鹵36.38minVS 134.37 鹵57.31 min (t 2.575min), there was significant difference between the two groups (P < 0.05). Postoperative hospitalization time in the endoscopic group was 7.02 鹵2.37 days shorter than that in the microscope group (8.00 鹵2.78 days), there was significant difference in postoperative complications: the incidence of cerebrospinal fluid leakage in the endoscopic group was higher than that in the microscope group, and there was no significant difference in the incidence of cerebrospinal fluid leakage between the endoscopic group and the microscope group (蠂 2, 0.519, p 0.471). The incidence of diabetes insipidus in the endoscopic group was 1.2VS3.2significantly lower than that in the microscope group, and there was no significant difference in the incidence of infection between the endoscopic group and the microscope group, and the incidence of infection in the endoscopic group was lower than that in the microscope group, and the incidence of infection in the endoscopic group was lower than that in the microscope group, and there was no significant difference in the incidence of infection between the endoscopic group and the microscope group. The incidence of hemorrhage in the endoscopic group was lower than that in the microscope group, and the incidence of epistaxis in the endoscopic group was 9.4VS1.60.There was a significant difference between the endoscopic group and the microscope group. Conclusion: the endoscopic transsphenoidal pituitary adenoma resection was compared with the microscopically transsphenoidal pituitary adenectomy. The total resection rate of tumor is high, the operation time is short, the hospitalization time is short, the incidence of diabetes insipidus, infection and bleeding is low, but cerebrospinal fluid leakage, The incidence of epistaxis is high. Generally speaking, endoscopic transsphenoidal pituitary adenoma resection is superior to microscopically transsphenoidal pituitary adenoma resection.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R736.4
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本文編號(hào)：1675073