侵犯視神經(jīng)管鞍區(qū)腦膜腫瘤術(shù)后視力影響因素分析
發(fā)布時(shí)間:2018-05-18 03:04
本文選題:視神經(jīng)管 + 腦膜腫瘤。 參考:《中國(guó)神經(jīng)精神疾病雜志》2017年09期
【摘要】:目的探討改善侵犯視神經(jīng)管的腦膜腫瘤術(shù)后視力水平的影響因素。方法收集侵犯視神經(jīng)管的腦膜腫瘤患者的臨床資料,logistic回歸分析性別、年齡、腫瘤大小、術(shù)前視力、腫瘤切除程度、腫瘤粘連周圍結(jié)構(gòu)程度、視神經(jīng)管減壓時(shí)機(jī)和患者視力轉(zhuǎn)歸的關(guān)系。結(jié)果共55例,術(shù)后視力改善26例,無(wú)改善29例。早期硬膜外視神經(jīng)管減壓17例,視力好轉(zhuǎn)15例;后期視神經(jīng)管減壓9例,視力好轉(zhuǎn)5例;單純刮除29例,視力好轉(zhuǎn)6例。單因素分析提示切除級(jí)別、腫瘤粘連程度和早期硬膜外視神經(jīng)管減壓可影響術(shù)后視力改善;logistic回歸分析顯示早期硬膜外視神經(jīng)管減壓是改善術(shù)后視力的唯一保護(hù)因素。結(jié)論對(duì)于術(shù)前考慮已經(jīng)侵犯視神經(jīng)管的鞍區(qū)腦膜腫瘤,術(shù)中宜行早期硬膜外視神經(jīng)管減壓以改善患者術(shù)后視力。
[Abstract]:Objective to investigate the influencing factors on postoperative visual acuity of meningeal tumors invading optic canal. Methods the clinical data of patients with meningeal tumor invading optic canal were collected. Logistic regression analysis was performed on sex, age, tumor size, preoperative visual acuity, degree of tumor resection, degree of surrounding structure of tumor adhesion. The relationship between the time of optic canal decompression and the outcome of visual acuity. Results in 55 cases, the visual acuity was improved in 26 cases and no improvement in 29 cases. 17 cases had early decompression of epidural optic canal, 15 cases had improved visual acuity, 9 cases had decompression of optic canal and 5 cases had improved visual acuity, 29 cases had simple curettage, 6 cases had improved visual acuity. Univariate analysis showed that resection grade, degree of tumor adhesion and early decompression of epidural optic canal could affect postoperative visual acuity. Logistic regression analysis showed that early decompression of epidural optic canal was the only protective factor to improve postoperative visual acuity. Conclusion in order to improve the postoperative visual acuity of patients with Sellar meningiomas which have invaded optic canal before operation, early decompression of epidural optic canal should be performed during operation.
【作者單位】: 佛山市第一人民醫(yī)院神經(jīng)外科;中山大學(xué)附屬第一醫(yī)院神經(jīng)外科;
【基金】:佛山市自籌經(jīng)費(fèi)類科技計(jì)劃項(xiàng)目(編號(hào):2014AB00282)
【分類號(hào)】:R739.45
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