神经内镜下经鼻蝶入路垂体瘤切除术对老年垂体瘤患者垂体视觉及嗅觉功能的影响OA

Objective To investigate the effects of transsphenoidal pituitary tumor resection(TPTR)under neuroendoscope on pituitary function,visual function,olsmell function and complications in elderly patients with pituitary tumor.Methods Totally 79 elderly patients with pituitary tumor who underwent surgical treatment in the Nanyang Second General Hospital from January 2020 to June 2023 were retrospectively selected.They were divided into microscope group(40 cases)and neuroendoscope group(39 cases).Perioperative indexes,total tumor resection rate,complications,pituitary function indexes(serum TSH,HGH,ACTH level),visual function indexes(VFI,PSD value,MD value)and olfactory recognition domain were compared between the microscope group and the neuroendoscope group.Results In the neuroendoscopy group,the operation time and hospitalization days were shorter than those in the microscope group,and the total intraoperative blood loss was less than that in the microscope group(P＜0.05).The total tumor resection rate in the neuroendoscopy group was higher than that in the microscope group(89.74％vs 70.00％),and the total incidence of postoperative complications was lower than that in the microscope group(5.13％vs 22.50％,x2=4.766,4.972,respectively,P＜0.05).After 1 month of operation,serum TSH,ACTH and HGH levels in the neuroendoscopy group were lower than those in the microscope group(P＜0.05),the VFI and MD values in the neuroendoscopy group were higher than those in the microscope group,while the PSD values and olfactory recognition domain were lower than those in the microscope group(P＜0.05).Conclusion Compared with TPTR under microscope,TPTR under neuroendoscope can further shorten the operation time,reduce the total intraoperative blood loss,increase the total tumor resection rate,reduce postoperative complications,better regulate hormone levels,less damage to olfactory function,better recovery of visual function,and contribute to rapid postoperative recovery.