PDF(Pubmed)
Abstract：
BACKGROUND: The neuroendoscopic approach has the advantages of a clear operative field, convenient tumor removal, and less damage, and is the development direction of modern neurosurgery. At present, transnasal surgery for sphenoidal pituitary tumor is widely used. But it has been found in clinical practice that some patients with this type of surgery may experience post-operative nausea and vomiting and other discomforts.
OBJECTIVE: To explore the effect of reserved gastric tube application in the neuroendoscopic endonasal resection of pituitary tumors.
METHODS: A total of 60 patients who underwent pituitary adenoma resection via the endoscopic endonasal approach were selected and randomly divided into the experimental and control groups, with 30 in each group. Experimental group: After anesthesia, a gastric tube was placed through the mouth under direct vision using a visual laryngoscope, and the fluid accumulated in the oropharynx was suctioned intermittently with low negative pressure throughout the whole process after nasal disinfection, during the operation, and when the patient recovered from anesthesia. Control group: Given the routine intraoperative care, no gastric tube was left. The number of cases of nausea/vomiting/aspiration within 24 h post-operation was counted and compared between the two groups; the scores of pharyngalgia after waking up, 6 h post-operation, and 24 h post-operation. The frequency of postoperative cerebrospinal fluid leakage and intracranial infection were compared. The hospitalization days of the two groups were statistically compared.
RESULTS: The times of postoperative nausea and vomiting in the experimental group were lower than that in the control group, and the difference in the incidence of nausea was statistically significant (P < 0.05). After the patient woke up, the scores of sore throat 6 h after the operation and 24 h after operation were lower than those in the control group, and the difference was statistically significant (P < 0.05). The number of cases of postoperative cerebrospinal fluid leakage and intracranial infection was higher than that of the control group, but there was no statistically significant difference from the control group (P > 0.05). The hospitalization days of the experimental group was lower than that of the control group, and the difference was statistically significant (P < 0.05).
CONCLUSIONS: Reserving a gastric tube in the endoscopic endonasal resection of pituitary tumors, combined with intraoperative and postoperative gastrointestinal decompression, can effectively reduce the incidence of nausea, reduce the number of vomiting and aspiration in patients, and reduce the complications of sore throat The incidence rate shortened the hospitalization days of the patients.
OBJECTIVE: To explore the effect of reserved gastric tube application in the neuroendoscopic endonasal resection of pituitary tumors.
METHODS: A total of 60 patients who underwent pituitary adenoma resection via the endoscopic endonasal approach were selected and randomly divided into the experimental and control groups, with 30 in each group. Experimental group: After anesthesia, a gastric tube was placed through the mouth under direct vision using a visual laryngoscope, and the fluid accumulated in the oropharynx was suctioned intermittently with low negative pressure throughout the whole process after nasal disinfection, during the operation, and when the patient recovered from anesthesia. Control group: Given the routine intraoperative care, no gastric tube was left. The number of cases of nausea/vomiting/aspiration within 24 h post-operation was counted and compared between the two groups; the scores of pharyngalgia after waking up, 6 h post-operation, and 24 h post-operation. The frequency of postoperative cerebrospinal fluid leakage and intracranial infection were compared. The hospitalization days of the two groups were statistically compared.
RESULTS: The times of postoperative nausea and vomiting in the experimental group were lower than that in the control group, and the difference in the incidence of nausea was statistically significant (P < 0.05). After the patient woke up, the scores of sore throat 6 h after the operation and 24 h after operation were lower than those in the control group, and the difference was statistically significant (P < 0.05). The number of cases of postoperative cerebrospinal fluid leakage and intracranial infection was higher than that of the control group, but there was no statistically significant difference from the control group (P > 0.05). The hospitalization days of the experimental group was lower than that of the control group, and the difference was statistically significant (P < 0.05).
CONCLUSIONS: Reserving a gastric tube in the endoscopic endonasal resection of pituitary tumors, combined with intraoperative and postoperative gastrointestinal decompression, can effectively reduce the incidence of nausea, reduce the number of vomiting and aspiration in patients, and reduce the complications of sore throat The incidence rate shortened the hospitalization days of the patients.
摘要：
背景：神经内窥镜入路具有手术视野清晰的优点，方便肿瘤切除，和较少的损害，是现代神经外科的发展方向。目前,经鼻手术治疗蝶窦垂体瘤应用广泛。但在临床实践中发现，一些接受此类手术的患者可能会出现术后恶心呕吐等不适。
目的：探讨保留胃管在神经内镜经鼻垂体瘤切除术中的应用效果。
方法：选择经鼻内镜下行垂体腺瘤切除术患者60例，随机分为实验组和对照组。每组30人。实验组:麻醉后,使用视觉喉镜在直视下将胃管穿过口腔，在鼻腔消毒后的整个过程中，在低负压的情况下间歇性地抽吸积聚在口咽中的液体，手术期间,当病人从麻醉中恢复时.对照组：给予常规术中护理，没有留下胃管。统计并比较两组患者术后24h内发生恶心/呕吐/误吸的例数;苏醒后咽痛评分,术后6小时,术后24小时。比较术后脑脊液漏和颅内感染的发生频率。对两组患者的住院天数进行统计学比较。
结果：试验组术后恶心呕吐次数低于对照组，恶心发生率差异有统计学意义(P<0.05)。病人醒来后，术后6h和24h咽喉痛评分均低于对照组,差异有统计学意义(P<0.05)。术后脑脊液漏和颅内感染的例数高于对照组,与对照组比较差异无统计学意义(P>0.05)。实验组住院天数低于对照组,差异有统计学意义(P<0.05)。
结论：在垂体瘤的内镜经鼻切除术中保留胃管，联合术中术后胃肠减压,能有效降低恶心的发生率,减少患者呕吐和误吸的次数，减少咽喉痛并发症的发生率,缩短患者的住院时间。
目的：探讨保留胃管在神经内镜经鼻垂体瘤切除术中的应用效果。
方法：选择经鼻内镜下行垂体腺瘤切除术患者60例，随机分为实验组和对照组。每组30人。实验组:麻醉后,使用视觉喉镜在直视下将胃管穿过口腔，在鼻腔消毒后的整个过程中，在低负压的情况下间歇性地抽吸积聚在口咽中的液体，手术期间,当病人从麻醉中恢复时.对照组：给予常规术中护理，没有留下胃管。统计并比较两组患者术后24h内发生恶心/呕吐/误吸的例数;苏醒后咽痛评分,术后6小时,术后24小时。比较术后脑脊液漏和颅内感染的发生频率。对两组患者的住院天数进行统计学比较。
结果：试验组术后恶心呕吐次数低于对照组，恶心发生率差异有统计学意义(P<0.05)。病人醒来后，术后6h和24h咽喉痛评分均低于对照组,差异有统计学意义(P<0.05)。术后脑脊液漏和颅内感染的例数高于对照组,与对照组比较差异无统计学意义(P>0.05)。实验组住院天数低于对照组,差异有统计学意义(P<0.05)。
结论：在垂体瘤的内镜经鼻切除术中保留胃管，联合术中术后胃肠减压,能有效降低恶心的发生率,减少患者呕吐和误吸的次数，减少咽喉痛并发症的发生率,缩短患者的住院时间。
