Background: Pituitary adenomas (PAs) are tumors that arise from the cells of the anterior pituitary gland. PAs are the most common tumors to occur in the sella area and the third most common intracranial neoplasm in surgery. Due to developments such as microscopy and neuroendoscopy, the curative effect of PA surgery continues to improve. However, postoperative complications may still occur. PA surgery can result in iatrogenic trauma, which is a primary cause of cerebrospinal fluid (CSF) rhinorrhea. PA surgery can affect the posterior pituitary gland, causing decreased antidiuretic hormone secretion and increased urine output, which can lead to hyponatremia. The nasal cavity and sphenoid sinuses may also be damaged during PA surgery, causing the sphenoethmoidal recess to be blocked. This increases the risk of infection. The purpose of this study was to analyze quality of life in PA patients post-resection, and to provide references for the development of early targeted risk assessment programs and intervention measures. Methods:We selected patients who underwent neuroendoscopic transnasal PA resection at the Affiliated Hospital of Nantong University between January 2017 and October 2019. These patients' hospital records were retrospectively obtained, including details of any postoperative complications. The patients were followed up by telephone 12 weeks following discharge, and we used the EuroQol 5 Dimensions (EQ-5D) health scale to assess the patients' quality of life.Results: At follow-up 3 months after discharge, 68 people (41.72%) had experienced at least one common complication, including 7 cases of infection (4.29%), 56 cases of hypopituitarism (34.36%), 18 cases of CSF rhinorrhea (11.04%), 28 cases of diabetes insipidus (17.18%), and 25 cases of hyponatremia (15.34%).Patients that experienced complications reported having more serious problems on the dimensions of the EQ-5D descriptive system (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) than patients without complications. The scores of patients with complications on the EQ-5D visual analog scale (EQ-VAS) were lower than that of patients without complications.Conclusions: Postoperative complications are negatively associated with quality of life in PA patients.Actively preventing common complications could therefore improve these patients' quality of life and reduce their burden of disease.
Background: The olfactory function decline of patients with postoperative pituitary adenoma is a common phenomenon. In order to establish a surgical access to the skull base, the upper turbinate, posterior ethmoid chamber and sphenoid sinus need to be operated. We can objectively understand the patient's nasal situation through the scale during the hospital stay, but we know little about the patient's actual feelings and troubles in the home rehabilitation phase.Methods: A qualitative study based on 15 semi-structured face-to-face interviews in a provincial comprehensive hospital was conducted. Participants were purposively selected until data saturation. Each interview was digitally recorded and lasted from 30 to 45 minutes. A trained and experienced interviewer collected all data. The Colaizzi method was used to analyze the data.Results: A total of six themes were obtained, namely, the patient's perception of symptoms and any accompanying symptoms and signs related to olfactory function decline, negative emotions, decreased appetite, decreased sleep quality, decreased libido, and the need for the continuous care of patients.Conclusions: A widespread occurrence of impaired smell and nasal function in patients with pituitary adenoma after endoscopic transsphenoidal surgery. It was also noted that nurses should intensify the postoperative nasal care of patients and develop good preventive measures to reduce their postoperative discomfort.
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