目的 探讨神经导航辅助神经内镜经鼻蝶入路切除垂体瘤的疗效。方法 将2014年10月—2018年4月我院接诊的20例垂体瘤患者纳入本研究,按照随机数字表法均分为观察组和对照组各10例,对照组患者行常规神经内镜下经鼻蝶入路垂体瘤切除术,观察组患者行神经导航辅助神经内镜下经鼻蝶入路垂体瘤切除术,比较两组患者手术及术后住院情况(包括手术时间、术中出血量及术后住院时间)、手术效果(包括显效率和总有效率)、手术前后血清内分泌指标变化情况(包括GH、PRL水平)以及术后并发症情况(即术后并发症发生率)。结果 观察组患者手术时间、术中出血量及术后住院时间均低于对照组,差异有统计学意义(P＜0.05);观察组显效率和总有效率均略高于对照组,但两组间手术效果并差异无统计学意义(P＞0.05);观察组患者治疗后血清生长激素(GH)、催乳素(PRL)水平均低于对照组,差异有统计学意义(P＜0.05);两组患者术后并发症发生率无统计学差异。结论 神经导航辅助神经内镜经鼻蝶入路切除垂体瘤疗效显著,手术时间短、术中出血少、术后恢复快,可明显改善患者内分泌指标,值得临床推荐。

Objective To evaluate the efficacy of resection for pituitary tumors through transsphenoidal approach with endoscopic neuronavigation assisted. Methods From October 2014 to April 2018, 10 patients with pituitary tumor were operated in our hospital with neuronavigation, which were set as the observation group. Meanwhile, 10 patients with pituitary tumor underwent surgical treating through transsphenoidal approach without neuronavigation were set as the control group. SPSS 19.0 were used for statistical analysis to compare the difference between the two groups, including the operation time, blood loss, hospitalization time, hormone level, clinical total efficiency, and complications in the two groups. Results The operation time, blood loss and hospitalization time of the observation group were less than that of the control group, and there was statistical significance (P<0.05). The efficiency rate and overall efficiency rate of the observation group were a little more than that of the control group, but there was no statistical significance (P＞0.05). The level of growth hormone (GH) and prolactin (PRL) of the observation group were less than that of the control group, and there was statistical significance (P<0.05). And there was no statistical significance between the incidence rate of postoperative complications of the two groups. Conclusion The efficacy of resection for pituitary tumors through transsphenoidal approach with endoscopic neuronavigation is significant, which may shorten the course, reduce the blood loss, quicken recovery of a patient from operation, and improve the hormone level. It is worthy to be recommended to clinical application.

目的 了解广州市社区医务人员对颈动脉狭窄防治知识的认知程度、认知途径及对相关健康教育的需求情况。方法 对37家社区卫生服务中心194名广州市社区医务人员进行问卷调查,分析调查结果。结果 社区医务人员中52.58%能够指出颈动脉狭窄与脑卒中的关系,但对症状性颈动脉狭窄定义、颈动脉狭窄的外科治疗方法知晓率偏低(14.95%、18.56%),97.94%能够指出颈部彩超是颈动脉狭窄最常用的筛查方法,但对彩超结果判读、干预方法指导等方面内容掌握率偏低。对颈动脉狭窄知识来源目前最主要的是用药指南和药品说明书(33.89%)认为最有效获得颈动脉狭窄知识的途径是专题继续教育培训班(26.12%)。结论 社区医务人员已经形成了脑卒中和颈动脉狭窄的基本观念,但是不能达到足够的“深度”,通过开展多种形式继续教育,增进社区医务人员对颈动脉狭窄认知的广度和深度,引导和拓宽获得知识的途径将是必要和有效的。

Objective To understand the knowledge and needs of carotid stenosis prevention among community health workers in Guangzhou. Methods A Kirkpatrick model-based questionnaire survey was conducted among 194 health workers in community health service center in Guangzhou. Results 52.58% of the community medical staff could point out the relationship between carotid stenosis and stroke, but few of them could accurately point out the definition and surgical treatment of symptomatic carotid stenosis(14.95%,18.56%). 97.94% of them could pointed out that the most commonly used screening methods for cervical carotid stenosis, but most of them didn't know how to interpret the inspection result of color doppler ultrasound. Medication guide were the main knowledge source of carotid stenosis(33.89%) and post-graduate training was the most promising approach(26.12%). Conclusion Community health workers have formed the basic concept of stroke and carotid stenosis, but it was limited in extent. It is necessary to carry out various forms of continuing education to improve the level of awareness of community health workers on carotid artery stenosis.