影响鞍结节脑膜瘤术后视力改善的因素分析

An analysis of factors influencing postoperative visual outcome of tuberculum sellae meningiomas

目的研究影响鞍结节脑膜瘤术后视力改善的因素。方法回顾性分析了2003年1月至2008年5月行显微手术治疗的45例鞍结节脑膜瘤患者的临床资料。以单眼为对象，分别对可能的影响因素行单因素分析及多因素分析。结果全切35例，次全切10例。术后视力改善54只，无明显变化24只，恶化12只。统计分析显示术前视盘改变、肿瘤与视神经关系、侵及方向、年龄、视力下降时间及程度、肿瘤大小、质地及切除程度与术后视力改善密切相关（P〈0．05）。结论术前视盘改变、肿瘤与视神经关系、侵及方向是影响术后视力改善最主要的因素。

Objective To study factors influencing postoperative visual outcome of tuberculum sellae meningiomas （TSMs）. Method The clinical materials of forty - five patients with TSMs treated microsurgically between January 2003 and May 2008 were analyzed retrospectively. As far as single eye was concerned, One -way analysis and multiplicity was performed between potential influencing factors and postoperative visual acuity. Results Total tumor resection was achieved in 35 cases and subtotal in 10. Postoperatively, visual function improved in 54 eyes, remained unchanged in 24 while deteriorated in 12. Statistical analysis show that postoperative visual outcome correlate closely to change of optic disc, relationship between tumor and optic nerve, direction of tumor invasion, age, duration and severity of preoperative visual disturbance, texture of tumor, and extent of tumor removal. Conclusions Change of optic disc, relationship between tumor and optic nerve, and direction of tumor invasion are the most related factors influencing postoperative visual outcome.