【摘要】 ①目的探讨垂体瘤致视功能障碍的可能机制。②方法以手术治疗的48例垂体瘤患者为对象,回顾性分析其临床与MR I影像资料。③结果48例垂体瘤患者中,38例(79.2%)患者肿瘤向鞍上生长,视交叉受压向上移位,视力下降率和视野缺损率分别为77.6%和53.9%,10例(20.8%)患者视交叉未受肿瘤压迫,视力下降率和视野缺损率分别为60.0%和30.0%,分别比较两组患者的视力下降率和视野缺损率,差异均无显著性(P>0.05)。在25例肿瘤偏一侧生长的患者中,18例同侧视力下降较对侧明显,13例同侧视野缺损较对侧严重。④结论肿瘤对视交叉的机械压迫可能不是患者出现视力下降和视野缺损的关键因素,而视交叉供血动脉受累或肿瘤增殖活跃"窃取"视交叉的血液可能是患者出现视功能障碍的主要原因。当肿瘤偏一侧生长时,该侧视功能障碍往往较对侧明显,可能是该侧视交叉供血动脉受累亦较严重所致。更多还原

【Abstract】 Objective To demonstrate the mechanism of visual disturbance(VD) caused by pituitary adenomas(PAs).Methods Forty eight patients with PAs were treated by operation and their medical records and MRI radiological films were analyzed.Results Of 48 patients,there were 38 cases(79.2%) with the suprasellar extension of the tumors and the upwards displacement of the OCs.The rates of the visual loss(VL) and the visual field defects(VFDs) were 77.6% and 53.9%,respectively.There were 10 cases without chiasmal involvement.The rates of the VL and the VFDs were 60.0% and 30.0% respectively.The difference of the rates of the VL between the two groups was no statistical significance(P>0.05) and so it was in VFDs(P>0.05).Ipsilateral VL was more dominant than contralateral one in 18 of 25 patients with lateral-shifted tumors.Ipsilateral VFDs was more severe than that of opposite side in 13 of 25 patients with lateral-shifted tumors.Conclusion The mechanical compression from the tumor might not be the critical factor which would lead to VL and VFDs of patients with PAs.The chiasmal nourishing arteries being involved and "steeling blood" mechanism might be the main reasons.Ipsilateral VD was usually more severe than contralateral one when a patient with a lateral-shifted lesion,possibly with the ipsilateral chiasmal arteries damaged more prominently as well.更多还原