急性垂体卒中后视功能改变的临床分析

Clinical analysis of visual function after acute pituitary apoplexy

目的探讨垂体卒中后视功能损害的原因、临床特点及最佳治疗方案。方法回顾性分析37例垂体卒中患者的临床资料,包括临床表现、影像学检查、治疗方案和预后。结果本组经蝶窦手术27例,其中视力完全恢复17例,明显恢复7例,略恢复3例。10例术后发生垂体功能低下,其中6例需要长期激素替代疗法。经颅手术治疗10例,视力完全恢复3例,明显恢复3例,略恢复2例,视力障碍加重2例。8例术后出现垂体功能低下,其中5例需要长期激素替代治疗。结论经蝶窦手术较经颅手术对视力影响小、并发症少,尽早手术能有效逆转视力损害。

Objective To explore tbe pathogenesis ,clinical characteristics and the best choice of visual function after pituitary apolexy （PA） . Methods The clinical data including clinical characteristics,imaging examination, treatment and prognosis of 37 patients with PA were analyzed retrospectively. Results In our patients treated by transsphenoidal approach, the visual disorders were cured in 17 patients,improved remarkably in 7 and improved slightly in 3. Ten patients were treated by transcranial approach. Among them,the visual disorder healed in 3, improved remarkably in 3,sligntly in 2 and aggravated in 2. The incidence of pituitary hypofunction were 10 of 27 in transsphenoidal group compared with 8 of 10 in another group. Substitutive treatments were required in 6 patients after transsphenoidal surgery, when 5 patients after transcranal surgery. Conclusions Compared with transcranial group,transsphenoidal surgery have the advantanges of less invasion and less complications. Early surgery can effectively reverse the visual impairments.