60例垂体瘤患者术前视野改变

Preoperative visual field changes of 60 cases of pituitary tumour

目的：应用动态视野仪检查垂体瘤患者的视野改变。方法：采用美国 TRS-4000 型声控动态视野仪，对 60 例垂体瘤患者的 120 只眼，行 60°、72 个刺激点视敏度检查，并与其 CT、MRT 检查做对照分析。结果：60 例垂体瘤患者术前视野检查阳性检出率为 68.33％，结果正常者占 31.6％。而 CT、MRI检查阳性检出率为 70％，正常者 4 例，占 6.77％，经统计学检验两者结果有一致性，χ2＝0.08，P＞0.05。虽然视野的阳性检出率低于 CT 及 MRI，但视野阳性的诊断价值是 100％，无假阳性。120 只眼有 49 只眼为偏盲，占 40.83％，偏盲以中线对劈为特点，偏盲多于缺损、暗点和全盲。结论：垂体瘤患者的视野改变有偏盲、暗点、缺损等，其部位、性质对垂体瘤的早期诊断、手术定位及进路均有重要意义。

Objective:To locate the location and range of neoplasms in visual path using dynamic perimeter.Methods:visual acuity with 60. and 72 dots were checked in 60° and 72 dots were checked in 60 cases of pituitary tumour using American TFS-4000 type sound control dynamic perimeter as compared with CT and MRI checking.Results:The positive rate of visual field before operation was 68.33% and the negative rate was 31.6%. The positive rate of CT and MRI was 70% and 4 cases were normal (6.77%). Statistic checking showed coherence between the two results, χ2＝0.08，P＞0.05Although the positive rate of visual field was lower than that of CT and MRI, the diagnostic value of positive visual field was 100% and there was no false poitiveness. 49 eyes of the 120 eyes showed hemianopsia (40.83%), it was characteristically divided by the central line. The number of hemianopsia was more than defect, blind dots and full blind. Conclusion:The visual field changes of pituitary tumour showed hemianopsia, blind dots, defect etc.. Their location and nature have important significance in early diagnosis, surgical location and surgical path.