【摘要】 目的观察患者行单鼻孔内镜下经鼻蝶垂体瘤切除术后视野恢复情况,分析其影响因素。方法选择2012年3月至2013年3月新疆医科大学第一附属医院经磁共振成像(MRI)检查确诊为垂体瘤的患者78例(156只眼),于术前行视力、视野、眼底荧光造影及垂体MRI平扫加增强检查。术前全部行中心视野检查,于术后3~6个月进行视野评估,并行垂体MRI平扫加增强检查、内分泌检查。对影响因素进行单因素分析和多因素Logistic回归分析。结果视野恢复正常组和视野部分恢复组患者的平均年龄、肿瘤最大直径、术前MD值的绝对值、术前视力、症状持续时间比较差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,年龄、术前MD绝对值、肿瘤最大直径是影响患者术后视野恢复的危险因素(P<0.05)。结论垂体瘤患者术前的MD绝对值低,肿瘤最大直径较小和年龄较小,在内镜经鼻蝶垂体瘤切除术后,视野的恢复的程度更好。更多还原

【Abstract】 Objective To observe the visual fields( VF) recovery after endoscopic endonasal transsphenoidal approach for pituitary tumor resection,and analyze the influential factors. Methods A total of 78patients( 156 eyes) with pituitary tumor from the First Affiliated Hospital of Xingjiang Medical University during Mar. 2012 and Mar. 2013 were selected,central VF examination was performed on all patients before operation,and VF assessment,pituitary plain and contrast enhanced MRI,and endocrine exanimation were performed 3-6 months after surgery. And single factor analysis and multivariate Logistic regression analysis were done on the influential factors. Results There were significant differences in average age,tumor size,preoperative MD absolute values,preoperative visual acuity,duration of symptoms between the view normal recovery group and vision partial recovery group( P < 0. 05). Logistic regression analysis showed age,preoperative MD absolute value,the largest tumor diameter were the risk factors of postoperative vision recovery( P <0.05). Conclusion Patients with pituitary tumors who have low preoperative MD absolute value,low craniocaudal diameter of tumour and younger age would have a better vision field recovery after trans-sphenoidal approach for pituitary tumors.更多还原