微创医学

目的探讨电磁神经导航在神经内镜下经鼻蝶入路垂体瘤切除术中应用的临床价值。方法选取2020年7月至2022年12月南宁市第一人民医院神经外科收治的40例垂体瘤患者为研究对象，采用随机数字法分将患者分为观察组和对照组，每组20例。观察组采用电磁神经导航引导神经内镜下经鼻蝶入路垂体瘤切除术，对照组采用单纯神经内镜下经鼻蝶入路垂体瘤切除术。比较两组患者的手术相关指标、手术效果、并发症及手术前后泌乳素（PRL）、生长激素（GH）、促肾上腺素皮质激素（ACTH）、促甲状腺素（TSH）、促卵泡生成素（FSH）等激素水平变化情况。结果两组患者的手术时间、术中出血量、术后住院时间比较，差异均无统计学意义（均P>0.05）。观察组垂体瘤全切率高于对照组，差异有统计学意义（P<0.05）。术前、术后第1天、术后第3天、术后第7天，两组患者的PRL、ACTH、TSH水平比较，差异均无统计学意义（均P>0.05）。术后第1天、术后第3天、术后第7天，观察组患者的GH、FSH水平高于对照组，差异均有统计学意义（均P<0.05）。观察组术后并发症发生率为30.00%（6/20），对照组术后并发症发生率为40.00%（8/20），差异无统计学意义（P>0.05）。结论电磁神经导航应用于神经内镜下经鼻蝶入路垂体瘤切除术安全、有效，可以获得更高的肿瘤切除率，使用方便，定位准确。

Objective To investigate the clinical value of the application of electromagnetic neuronavigation in neuroendoscopic endonasal transsphenoidal pituitary tumor resection. Methods Forty patients with pituitary tumors admitted to the neurosurgery department of the First People's Hospital of Nanning from July 2020 to December 2022 were selected as the research subjects. The patients were divided into an observation group and a control group by random number method, with 20 cases in each group. The observation group underwent neuroendoscopic endonasal transsphenoidal pituitary tumor resection guided by electromagnetic neuronavigation, whereas the control group received conventional neuroendoscopic endonasal transsphenoidal pituitary tumor resection. Compare the surgical related indicators, surgical outcomes, complications, the pre- and post- surgical changes in hormone levels such as prolactin (PRL), growth hormone (GH), adrenocorticotropic hormone (ACTH), thyroid stimulating hormone (TSH), follicle stimulating hormone (FSH) between two groups of patients. Results There was no statistically significant difference in operation time, intraoperative blood loss, and postoperative hospitalization time between the two groups of patients (all P>0.05). The total removal rate of pituitary tumors in the observation group was higher than that in the control group, with statistically significant difference (P<0.05). Before surgery, as well as on the 1st, 3rd, and 7th days after surgery, there was no statistically significant difference in the levels of PRL, ACTH, and TSH between the two groups (all P>0.05). On the 1st, 3rd, and 7th days after surgery, the levels of GH and FSH in the obserbation group were significantly higher than those in the control group, with statistically significant differences (all P<0.05). The incidence of postoperative complications in the observation group was 30.00% (6/20), wheras that in the control group was 40.00% (8/20), with no statistically significant difference (P>0.05). Conclusion The application of electromagnetic neuronavigation in neuroendoscopic endonasal trans-sphenoidal pituitary tumor resection is safe and effective, which can obtain a higher tumor resection rate, and it is easy to use with accurate positioning.

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