摘要
Objective To explore the best indication of neuroendoscopic surgery in patients with pituitary tumors by comparing the clinical effects of neuroendoscopic transsphenoidal surgery on patients with different types of pituitary tumors.MethodsA total of 92 patients with different types of pituitary adenoma received transsphenoidal approach under neuroendoscopy in our hospital from June 2016 to October2017 were selected, the surgical results were evaluated by comparing the postoperative hormone levels were normal or not and the tumor were resected or not.The patients were followed up, the physiological function (PF), physiological function (RP), emotional functions (RE) was determined by health measurement scale (SF-36) to evaluated the quality of life of patients.Results There were differences in clinical efficacy of neuroendoscopy for the treatment of different types of pituitary adenoma, the cure rate from high to low in turn was cortical hormone adenomas, growth hormone adenomas, prolactin adenomas, mixed adenoma, non-functional adenomas, the cure rate of functional pituitary adenoma was obviously higher than that of no functional pituitary adenoma, the difference was statistically significant (P<0.05).At 6 months after surgery, SF-36 result showed that PF scores was (76.30±8.68), RP scores was (78.37±19.05), RE scores was (71.54±21.54), and at 12 months after surgery, PF scores was (87.20±9.24), RP scores was (78.66±15.18) and RE scores was (87.80±17.67), which were higher in patients with functional pituitary adenoma than those in patients with non-functional pituitary adenoma, the differences were significant (P<0.05).ConclusionThe treatment of functional pituitary tumor by neuroendoscopic surgery, especially corticosteroid adenoma, has the best effect, and can significantly improve the quality of life of patients.
摘要
Objective To discuss the efficacy of microsurgery in meningioma around central gyrus region. Methods Seventy-one patients with parasagittal and parafalcine meningioma around central gyrus region were treated with microsurgery technique. Special attention was paid on the vein of central sulcus and other compensative venous pathways to protect them from being damaged; the affected sagittal sinuses were duly handled. Results Simpson grade Ⅰ resection was achieved in 45 patients (63.4%) ,grade Ⅱ in 17 (23.9%), near total resection in 9 (12.7%), and hemiparalysis happening in 5patients, and no patient died. Fourty-two patients was followed up for 1 to 5 years without recurrence.Conclusion choosing the strategy of preserving the function of central gyrus region and improving the microsurgical technique in treating meningioma around central gyrus region can decrease the injuries to significancant domain of the brain.
摘要
Objective To study the clinical features and to improve the treatment on the elderly patients with brain tumor.Methods Retrospective analysis of 163 cases with brain tumor which had been confirmed by CT,MRA or pathology.Results Of all the 163 cases,121 were located in supratentorium,most of which were meningiomas and gliomas.Most patients(129 cases)had comorbidity.After operation,symptoms disappeared or obviously improved in 126 cases,moderately improved in 19 cases,and did not changed in 6 patients.Twelve cases died after operation in a month, in which 9 patients were over 75 years old.The death rate of operation was 6.1%.Conclusions It is important to know the atypical manifestation of brain tumor in the elderly,which may prevent clinical misdiagnosis and mistherapy.The perioperative management is indispensable to the prognosis of the patients.The choice of operation and medication should be in individualized.