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-  2015 

磷酸钙人工骨在经鼻蝶入路垂体瘤切除术鞍底重建中的应用研究

DOI: doi:10.7507/1002-1892.20150301

Keywords: 垂体腺瘤切除术, 经鼻蝶手术, 鞍底重建, 脑脊液漏

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Abstract:

目的探讨经鼻蝶入路垂体瘤切除术中应用磷酸钙人工骨行鞍底重建的疗效。 方法回顾分析2014年1月-12月接受经鼻蝶入路垂体瘤切除术治疗的85例垂体腺瘤患者临床资料,其中46例采用“三明治”方法行鞍底重建(对照组),39例在“三明治”方法基础上联合磷酸钙人工骨(试验组)。两组患者性别、年龄、病程、肿瘤大小、侵袭性及鞍底破坏比较,差异均无统计学意义(P>0.05),具有可比性。 结果对照组肿瘤全切除39例、次全切除7例,试验组分别为33例和6例;两组比较差异无统计学意义(Z=-1.303,P=0.193)。对照组术中发生脑脊液漏8例、术后2周内发生脑脊液漏4例,试验组仅术中发生脑脊液漏10例;两组术中脑脊液漏发生率比较,差异无统计学意义(Z=-1.748,P=0.080),但试验组术后脑脊液漏发生率显著少于对照组(P=0.020)。试验组术后拔除纱条时间均为3 d,较对照组的(4.3±1.6)d显著缩短(t=2.236,P=0.033)。术后对照组35例获随访3~14个月,试验组33例获随访5~13个月。随访期间均无脑脊液漏发生。 结论经鼻蝶入路垂体瘤切除术中,在“三明治”方法基础上联合应用磷酸钙人工骨行鞍底重建,可有效降低术后脑脊液漏发生率,缩短纱条拔除时间

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