神经内镜扩大经鼻蝶切除术与开颅术切除颅咽管瘤的疗效对比

目的:研究颅咽管瘤患者采用神经内镜扩大经鼻蝶切除术与开颅术切除的临床效果。方法:临床纳入我院2015年6月至2018年1月期间收治的76例颅咽管瘤患者作为研究对象，按手术情况分为两组各38例。其中38例患者采用传统开颅切除术治疗作为开颅组，另38例患者采用神经内镜扩大经鼻蝶切除术治疗作为内镜组。观察两组患者手术情况、临床缓解率、肿瘤切除率以及并发症情况。结果:两组患者手术时间、出血量均无差异，P＞0.05；内镜组住院时间明显短于开颅组，P＜0.05。内镜组肿瘤全切率、临床缓解率分别为65.79%、86.84%，均高于开颅组的47.37%、55.26%，P＜0.05。两组患者并发症包括颅内感染、偏瘫、颅神经损伤、腺垂体功能减退以及癫痫。内镜组发生率仅为15.79%，明显低于开颅组的44.74%，P＜0.05。结论:神经内镜扩大经鼻蝶切除术治疗颅咽管瘤效果较好，患者预后较好，缩短住院时间，提高肿瘤全切率及临床缓解率，减少术后并发症，安全可靠，值得临床应用及推广。

Effect comparison of expended endoscopic endonasal transsphenoidal approach and craniotomy in the resection of craniopharyngioma

Objective:To study the clinical efficacy of expended endoscopic endonassal transsphenoidal approach and craniotomy in the resection of craniopharyngioma.Methods:76 craniopharyngioma patients treated from June 2015 to January 2018 in our hospital were selected.The subjects were assigned to craniotomy group and endoscopic group according to the different therapies,38 cases each group.Patients took the craniotomy or expended endoscopic endonassal transsphenoidal approach,respectively.The operation condition,relief rate,tumor resection rate and complications were explored.Results:There were no significant between-group difference in the operation time and bleeding volume (P＞0.05).The hospitalization time in the endoscopic group was significantly shorter than craniotomy group (P＜0.05).The complete tumor resection rate and relief rate in the endoscopic group (65.79%,86.84%) was higher than craniotomy group (47.37%,55.26%)(P＜0.05).The incidence rate of complications including intracranial infection,hemiplegia,cranial nerve injury,hypopituitarism and epilepsy in the endoscopic group (15.79%) was significantly lower than craniotomy group (44.74%)(P＜0.05).Conclusion:The expended endoscopic endonassal transsphenoidal approach can improve the patient's prognosis,shorten the hospitalization time,increase the complete tumor resection rate and relief rate and reduce the rate of postoperative complications.The safe and reliable therapy is worthy of clinical application and promotion.