本文關(guān)鍵詞： 視野缺損 垂體瘤 內(nèi)鏡經(jīng)鼻蝶垂體瘤切除術(shù) 視力　出處：《新疆醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：視野檢查在視路疾病的診斷上具有重要意義,而垂體腺瘤是造成視交叉損害較常見(jiàn)的病變。此研究對(duì)垂體腺瘤患者的術(shù)前及術(shù)后視野進(jìn)行定量評(píng)估,觀察患者行單鼻孔內(nèi)鏡下經(jīng)鼻蝶垂體瘤切除術(shù)后視野恢復(fù),探討術(shù)后視野恢復(fù)的影響因素。方法：回顧性分析新疆醫(yī)科大學(xué)第一附屬醫(yī)院2012年3月至2013年3月經(jīng)MRI檢查確診為垂體瘤的患者78例(156只眼),于術(shù)前行視力、視野、眼底熒光造影及垂體MRI平掃加增強(qiáng)檢查。術(shù)前全部行中心視野檢查,于術(shù)后7天內(nèi),3-6個(gè)月進(jìn)行視力、中心靜態(tài)視野評(píng)估,并行垂體MRI平掃加增強(qiáng)檢查,內(nèi)分泌檢查。對(duì)影響因素進(jìn)行單因素分析和多因素Logistic回歸分析。結(jié)果：視野缺損在顳上象限的頻率最高,其次是顳下。術(shù)后3-6個(gè)月的隨訪中,患者視野的恢復(fù)是漸進(jìn)的過(guò)程�？傮w來(lái)說(shuō),31.7%的眼睛視野恢復(fù)正常,術(shù)后視野改善59.1%,在9.2%保持不變。在單因素分析中,視野恢復(fù)正常組比視野改善組有一個(gè)較短的術(shù)前癥狀持續(xù)時(shí)間(P0.05)、更好的術(shù)前視力(P0.05),并在術(shù)前視野缺損的量值MD (the mean deviation)較小(P0.01),在多因素分析中,預(yù)測(cè)術(shù)后視野恢復(fù)積極的獨(dú)立的因素為術(shù)前低MD絕對(duì)值(P=0.008),,小的腫瘤最大直徑(P=0.04),和年輕的年齡(P=0.001)。結(jié)論：在單鼻孔內(nèi)鏡下垂體瘤切除術(shù)后,隨訪6個(gè)月后,視野逐步恢復(fù)正常和改善的有89.7%的病人。預(yù)測(cè)術(shù)后視野恢復(fù)積極的獨(dú)立的因素為術(shù)前低MD絕對(duì)值,較小的腫瘤直徑和年輕的年齡。
[Abstract]:Objective: visual field examination plays an important role in the diagnosis of optic diseases, and pituitary adenoma is a common lesion causing optic chiasma damage. To observe the recovery of visual field after transsphenoidal pituitary adenoma resection under single nostril endoscope. Methods: 78 patients with pituitary adenoma diagnosed by MRI from March 2012 to 2013 in the first affiliated Hospital of Xinjiang Medical University were treated with visual acuity and visual field before operation. All patients underwent central visual field examination before operation, visual acuity was performed 3-6 months after operation, central static visual field was evaluated, pituitary MRI plain scan and enhanced pituitary examination were performed. Endocrine examination. Univariate analysis and multivariate Logistic regression analysis of influencing factors. Results: the frequency of visual field defect was the highest in the superior temporal quadrant, followed by subtemporal. The recovery of visual field was a gradual process. In general, 31. 7% of the visual field returned to normal, the postoperative visual field improved 59. 1%, and remained unchanged in 9.2%. The patients with normal visual field recovery had a shorter duration of preoperative symptoms and better preoperative visual acuity than those with improved visual field (P 0.05), and the preoperative visual field defect (MD the mean deviation) was smaller than that of the visual field improvement group (P 0.01). The independent predictors of postoperative visual field recovery were preoperative low MD absolute value (P < 0.008), small tumor maximum diameter (P < 0.04), and young age (P < 0.001). Conclusion: after single-nostril endoscopic pituitary adenoma resection, the patients were followed up for 6 months. There were 89.7% patients whose visual field gradually returned to normal and improved. The independent factors of predicting the positive recovery of postoperative visual field were preoperative low MD absolute value, small tumor diameter and young age.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R739.41

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本文編號(hào)：1517075