单鼻孔内镜下经鼻蝶垂体瘤切除术后视野恢复情况

摘要

Objective:To study the visual field rehabilitation and its influence factors after the single-nostril transsphenoidal approach in the resection of pituitary adenoma under the endoscope.Methods:All 48 patients with pituitary adenoma (96 eyes) were selected.All the patients received the examinations of vision,visual field,fundus fluorescein angiography,MRI and central visual field.After 3~6 months of treatment,the visual field examination as well as MRI and internal secretion examination was conducted.The single and multiple Logistic regression analysis were made.Results:According to the single factor analysis,the visual field rehabilitation had a close correlation with the patient's age,max diameter of tumor,absolute value of MD,pre-operation vision,duration time,etc (P<0.05).According to the multiple Logistic regression analysis,the high risk factors of visual rehabilitation was the patient's age,absolute value of MD and max diameter of tumor (P<0.05).Conclusion:The single-nostril transsphenoidal approach in the resection of pituitary adenoma can efficiently treat the pituitary adenoma.For patients with lower absolute value of MD,smaller max diameter of tumor and younger age,the visual field can be recovered in a better way.%目的:观察垂体瘤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,探讨影响因素.方法:纳入垂体瘤患者48例(96只眼).所有患者术前均接受视力、视野、眼底荧光造影、垂体MRI、中心视野检查.术后3~6个月对患者的视野情况进行评估,同时进行垂体MRI以及内分泌检查.对于可能影响患者术后视野的因素进行单因素与多因素Logistic回归分析.结果:单因素分析显示:患者的年龄、肿瘤最大直径、术前MD值的绝对值、术前视力、症状持续时间等与患者术后视野恢复有着密切的联系(P<0.05).多因素Logistic回归分析显示:患者的年龄、术前MD值的绝对值、肿瘤最大直径是影响患者术后视野恢复的高危因素(P<0.05).结论:单鼻孔内镜下经鼻蝶垂体瘤切除术是目前临床治疗垂体瘤较为有效的一种手术方式,对于术前MD绝对值较低,肿瘤最大直径较小以及年龄较小的患者,术后视野恢复情况相对较好.