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对接受扩大经鼻内镜手术治疗良性垂体病变患者生活质量的前瞻性评估。

A Prospective Evaluation of Quality of Life in Patients Undergoing Extended Endoscopic Endonasal Surgery for Benign Pituitary Gland Lesion.

作者信息

Carmel Neiderman Narin Nard, Wengier Anat, Dominsky Omri, Ringel Barak, Warshavsky Anton, Horowitz Gilad, Baran Tomer Ziv, Ram Zvi, Grossman Rachel, Fliss Dan Marian, Avraham Abergel

机构信息

Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Department of Epidemiology, Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel.

出版信息

J Neurol Surg B Skull Base. 2021 May 29;83(Suppl 2):e386-e394. doi: 10.1055/s-0041-1730322. eCollection 2022 Jun.

Abstract

Endoscopic endonasal surgery (EES) has become the preferred approach for pituitary tumor resection. Nevertheless, research on quality of life related to pituitary adenoma surgery is scarce.  The aim of the study is to evaluate short-term quality of life in patients after endoscopic endonasal resection of pituitary tumors and to find predictors for poor quality of life (QOL) outcome.  A prospective cohort study was conducted, including all patients who underwent EES for pituitary tumors in a tertiary medical referral center. Recruited patients completed the Anterior Skull Base Disease-Specific QOL (ASBS-Q) questionnaire and the Sinonasal Outcome Test 22 (SNOT-22) questionnaire before surgery, 2 and 4 to 6 months after surgery. Demographic and clinical data was collected.  Our study included 49 patients. The overall ASBS-Q scores significantly improved 4 to 6 months after surgery (4.46 vs. 4.2,  < 0.05). We found a significant improvement in QOL related to emotional state 2 months post surgery (4.41 vs. 3.87,  < 0.05), which became borderline significant 4 to 6 months post surgery. There was a significant improvement in pain (4.5 vs. 4.08,  < 0.05) and vitality (4.43 vs. 4.16,  < 0.05) domains 4 to 6 months post surgery. SNOT-22 scores did not change significantly postoperatively. Factors such as secreting and non-secreting tumors, tumor size, intraoperative cerebrospinal fluid leak, gross tumor resection, endocrine remission, and the use of nasoseptal flap reconstruction did not have a significant effect on QOL.  We found that patients after EES reported improved QOL 4 to 6 months post surgery. Specific improvement was noted in the QOL related to pain and vitality.

摘要

鼻内镜下经鼻手术(EES)已成为垂体瘤切除的首选方法。然而,关于垂体腺瘤手术相关生活质量的研究却很少。

本研究的目的是评估垂体瘤鼻内镜下经鼻切除术后患者的短期生活质量,并找出生活质量(QOL)结果不佳的预测因素。

我们进行了一项前瞻性队列研究,纳入了在一家三级医疗转诊中心接受EES治疗垂体瘤的所有患者。招募的患者在手术前、术后2个月以及术后4至6个月完成前颅底疾病特异性生活质量(ASBS-Q)问卷和鼻窦结局测试22(SNOT-22)问卷。收集了人口统计学和临床数据。

我们的研究纳入了49例患者。术后4至6个月,ASBS-Q总分显著改善(4.46对4.2,P<0.05)。我们发现术后2个月与情绪状态相关的生活质量有显著改善(4.41对3.87,P<0.05),术后4至6个月这种改善接近显著水平。术后4至6个月,疼痛(4.5对4.08,P<0.05)和活力(4.43对4.16,P<0.05)领域有显著改善。SNOT-22评分术后无显著变化。分泌性和非分泌性肿瘤、肿瘤大小、术中脑脊液漏、肿瘤全切、内分泌缓解以及鼻中隔瓣重建的使用等因素对生活质量没有显著影响。

我们发现接受EES治疗的患者在术后4至6个月报告生活质量有所改善。在与疼痛和活力相关的生活质量方面有特定改善。

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Improving Quality of Life in Patients with Pituitary Tumours.提高垂体瘤患者的生活质量。
Eur Endocrinol. 2013 Mar;9(1):32-36. doi: 10.17925/EE.2013.09.01.32. Epub 2013 Mar 15.

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