经鼻蝶垂体腺瘤显微切除术后视觉恢复的术前影响因素分析

Analysis of preoperative affecting factors on visual function recovery after transsphenoidal pituitary adenoma microsurgical resection

目的探讨经鼻蝶垂体腺瘤显微切除术后视觉功能恢复情况并分析其术前影响因素。方法本文对59例经鼻蝶入路垂体腺瘤显微切除术后患者的临床资料进行了回顾性分析,并根据术后视觉改善情况,将患者分为未改善组(n=17)及改善组(n=42)两组,并对术后视觉变化与视觉功能恢复的术前影响因素进行分析。结果 59例垂体腺瘤患者中42例术前与术后视觉变化有显著性差异(P<0.01);通过比较两组患者临床资料中肿瘤最大直径、鞍上伸长、症状持续时间、患者年龄与患者术后视觉恢复情况,差异有统计学意义(P<0.01),经Logistic多因素回归分析发现鞍上伸长、症状持续时间、年龄为术后视觉未改善的独立危险因素(P<0.05),肿瘤最大直径并无统计学意义(P=0.449)。结论垂体腺瘤患者肿瘤鞍上伸长、症状持续时间、患者年龄是术后视觉未改善的危险因素,肿瘤最大直径并不是术后视觉改善的独立影响因素。

Objective To investigate the recovery of visual function after transsphenoidal pituitary adenoma microsurgical resection and analyze its preoperative affecting factors. Methods The clinical data of 59 patients received transsphenoidal pituitary adenoma microsurgical resection were analyzed retrospectively,according to the situation of postoperative visual improvement,the patients were divided into two groups: the group of un-improvement( n = 17) and group of improvement( n = 42),and the visual changes and the preoperative factors influencing visual function recovery were analyzed. Results Visual changes of 42 of 59 patients with pituitary adenoma were significant differences( P < 0. 01). There were statistically significant between the two groups on maximum tumor diameter,suprasellar extension,duration of symptoms,age of the patients,and the postoperative visual recovery( P<0.01).Multivariate logistic regression showed that suprasellar extension,duration of symptoms and age of the patients were the independent risk factors of visual un-improvement( P< 0.05),the difference of maximum tumor diameter was not statistically significant( P = 0. 449). Conclusions Suprasellar extension,duration of symptoms and age of the patients were the risk factors for postoperative visual recovery of pituitary adenomas,maximum tumor diameter was not the independent factor for postoperative visual recovery.