本文選題：垂體瘤 + 并發(fā)癥　； 參考：《浙江大學(xué)》2017年碩士論文

【摘要】：目的分析總結(jié)神經(jīng)內(nèi)鏡下經(jīng)鼻蝶入路垂體瘤切除術(shù)的并發(fā)癥及其相關(guān)危險(xiǎn)因素,為減少術(shù)后并發(fā)癥的發(fā)生提供理論依據(jù)與指導(dǎo)。方法收集浙江大學(xué)醫(yī)學(xué)院附.屬第二醫(yī)院神經(jīng)外科在2016年1月1日至2016年12月31日期間收治并行神經(jīng)內(nèi)鏡下經(jīng)鼻蝶入路垂體瘤切除術(shù)的患者共114例,對(duì)患者臨床資料進(jìn)行回顧性分析,總結(jié)術(shù)后并發(fā)癥,分別對(duì)患者的年齡、性別、體重指數(shù)、高血壓、糖尿病、吸煙史、飲酒史、術(shù)前視力障礙、術(shù)前內(nèi)分泌紊亂、腫瘤大小、手術(shù)時(shí)間、術(shù)中出血量、術(shù)中腦脊液漏、再次手術(shù)14個(gè)指標(biāo)行統(tǒng)計(jì)學(xué)分析,尋找其中與術(shù)后并發(fā)癥相關(guān)的危險(xiǎn)因素。結(jié)果總共114例納入研究的神經(jīng)內(nèi)鏡下垂體瘤切除術(shù)患者中,術(shù)后發(fā)生并發(fā)癥者70例(61.4%),其中出現(xiàn)腦脊液鼻漏10例(8.8%),顱內(nèi)感染5例(4.4%),低鈉血癥29例(25.4%),垂體功能低下16例(14.0%),尿崩癥46例(40.4%),鼻出血4例(3.5%),腦梗死1例(0.9%),肺炎1例(0.9%)。通過單因素統(tǒng)計(jì)學(xué)分析并未發(fā)現(xiàn)與內(nèi)鏡下垂體瘤切除術(shù)后發(fā)生并發(fā)癥顯著相關(guān)的危險(xiǎn)因素;然而亞組分析發(fā)現(xiàn),手術(shù)時(shí)間長(zhǎng)(≥3小時(shí))是發(fā)生腦脊液鼻漏的潛在危險(xiǎn)因素,吸煙史和飲酒史是發(fā)生顱內(nèi)感染的潛在危險(xiǎn)因素,年齡55歲和手術(shù)時(shí)間長(zhǎng)(≥3小時(shí))是發(fā)生尿崩癥的的潛在危險(xiǎn)因素;Logistic回歸分析顯示,手術(shù)時(shí)間長(zhǎng)(≥3小時(shí))是術(shù)后發(fā)生尿崩癥的危險(xiǎn)因素。結(jié)論顱內(nèi)感染、低鈉血癥、垂體功能低下、腦脊液鼻漏、尿崩癥、鼻出血等是神經(jīng)內(nèi)鏡下垂體瘤切除術(shù)的常見并發(fā)癥。手術(shù)時(shí)間長(zhǎng)(≥3小時(shí))是術(shù)后發(fā)生尿崩癥的危險(xiǎn)因素。
[Abstract]:Objective to analyze and summarize the complications and related risk factors of endoscopic transsphenoidal pituitary adenoma resection in order to provide theoretical basis and guidance for reducing the incidence of postoperative complications. Methods collected from the Medical College of Zhejiang University, affiliated to the Department of Neurosurgery of the second hospital from January 1, 2016 to December 31, 2016, were treated with parallel neuroendoscopy. A total of 114 patients with pituitary adenoma underwent transsphenoidal approach. The clinical data were retrospectively analyzed. The postoperative complications were reviewed. The patients' age, sex, body mass index, hypertension, diabetes, smoking history, drinking history, preoperative visual impairment, preoperative internal secretory disorder, tumor size, operation time, intraoperative bleeding, and intraoperative spinal cord were analyzed. A total of 114 cases included 70 cases (61.4%) of postoperative complications, including 10 cases of cerebrospinal fluid rhinorrhea (8.8%), 5 cases of intracranial infection (4.4%), 29 cases of hyponatremia (25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, 25.4%, and 25.4% There were 16 cases of hypophysis dysfunction (14%), 46 cases of diabetes insipidus (40.4%), 4 cases of nasal hemorrhage (3.5%), 1 cases of cerebral infarction (0.9%), 1 cases of pneumonia (0.9%). The risk factors that were significantly related to the complications after endoscopic pituitary adenoma resection were not found by single factor analysis. However, the subgroup analysis found that the operation time was longer (more than 3 hours) was the occurrence of the spinal cord. The potential risk factors of liquid rhinorrhea, smoking history and drinking history are potential risk factors for intracranial infection. Age 55 years and long operation time (more than 3 hours) are potential risk factors for diabetes insipidus. Logistic regression analysis shows that the long operation time (> 3 hours) is a risk factor for postoperative diabetes insipidus. Conclusion intracranial infection, low sodium Hypothyroidism, hypophysis dysfunction, cerebrospinal fluid rhinorrhea, diabetes insipidus, nasal bleeding, etc. are common complications of pituitary adenoma resection under neuroendoscopy. The long operation time (more than 3 hours) is a risk factor for postoperative diabetes insipidus.
【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)：1994395