CAJ | 학술논문

目的：研究鞍区肿瘤最常见的垂体瘤中心30°视野改变特点，分析垂体瘤患者术前术后的视野缺损特征，为术前的诊断及术后的恢复提供视野判断依据。方法回顾性病例系列研究。对2007年12月～2010年1月在昆明医科大学第一附属医院神经外科住院部治疗的视野有改变的垂体瘤患者35位患者（70只眼），右35眼，左35眼，男25例（50只眼），女10例（20只眼）；年龄30～60岁，术后病理学诊断确诊为垂体瘤的患者，经蝶窦入路切除垂体瘤术后90天内进行随访复查视野。比较术前术后视野指数MD（Mean de-fect）值；结果35例患者左眼MD值术前为-13．34±2．11dB，术后为-3．74±1．60dB；右眼MD值术前为-13．16±2．65 dB，术后MD值为-3．41±1．73dB，采用配对t检验，比较术前术后左眼MD值P＝0．000（P＜0．05），差异有统计学意义，比较术前术后右眼MD值P＝0．000（P＜0．05），差异有统计学意义。结论1．对于垂体瘤患者，MD值可以作为判断术前视野损害的指标之一，并且MD值也可以作为判断术后视野恢复的指标之一。2．．对于垂体瘤患者，经蝶窦入路切除垂体瘤手术能明显提高视力和视野。3．垂体瘤患者术前视野损害最大的象限是颞上象限。
목적：연구안구종류최상견적수체류중심30°시야개변특점，분석수체류환자술전술후적시야결손특정，위술전적진단급술후적회복제공시야판단의거。방법회고성병례계렬연구。대2007년12월～2010년1월재곤명의과대학제일부속의원신경외과주원부치료적시야유개변적수체류환자35위환자（70지안），우35안，좌35안，남25례（50지안），녀10례（20지안）；년령30～60세，술후병이학진단학진위수체류적환자，경접두입로절제수체류술후90천내진행수방복사시야。비교술전술후시야지수MD（Mean de-fect）치；결과35례환자좌안MD치술전위-13．34±2．11dB，술후위-3．74±1．60dB；우안MD치술전위-13．16±2．65 dB，술후MD치위-3．41±1．73dB，채용배대t검험，비교술전술후좌안MD치P＝0．000（P＜0．05），차이유통계학의의，비교술전술후우안MD치P＝0．000（P＜0．05），차이유통계학의의。결론1．대우수체류환자，MD치가이작위판단술전시야손해적지표지일，병차MD치야가이작위판단술후시야회복적지표지일。2．．대우수체류환자，경접두입로절제수체류수술능명현제고시력화시야。3．수체류환자술전시야손해최대적상한시섭상상한。
With the aim of providing materials for preoperative diagnosis as wel as postoperative prognosis of the visual field,this research investigates into the most common changes to the central 30 degree visual field in patients suf ering from pituitary carcinomas and analyzes characteristics of visual degeneration in such patients at both preoperative and postoperative stages. Method:In December 2007 to January 2010 in Kunming medical university first af il iated surgical in patient treatment of 35 patients(70eyes),35 right eyes ,35 left eyes ,25 male patients (50 eyes),10 female patients (20 eyes),with pituitary adenoma visual field has changed.Thirty five patients are from 30-60.Patients with postoperative pathological diagnosis of pituitary adeno-ma.By transsphenoidal approach resection of pituitary adenoma postoperative fol ow up and review the visual field in 90 days.To be specific,this research makes comparison between preopera-tive and postoperative Mean Defects indexes.Results:The result is 35 patients is the left preoperative Mean Defects indexes is -13.34 ±2.11dB,The left postoperative Mean Defects indexes is-3.74 ±1.60dB,The right preoperative Mean Defects indexes is -13.16 ±2.65 dB,The right postoperative Mean Defects indexes is -3.41 ±1.73dB.By using paired t test,There is an ob-vious pre /postoperative diference in MD indexes in left eyes.(P<0.05);And there is an obvious pre /postoperative diference in MD indexes in right eyes(P<0.05).Conclusion:1.For Pituitary adenoma treatment,MD index can be used as one of the indexes of preoperative harm of the visual filed and MD index can be also used as one of the indexes of postoperative recovery of the visual filed.2.For Pituitary adenoma treatment,transsphenoidal operation for resection of pituitary adenomas can apparently improve the vision and visual field.3.The superotemporal quadrant is the most harmful part to the preoperative patient’s vision degeneration.