CAJ | 학술논문

目的总结鞍区脑膜瘤的临床特征、影像学特征、显微手术入路的选择,并探讨影响患者术后视力恢复的因素.方法回顾性分析44例鞍区脑膜瘤患者的临床资料并对其进行随访研究,总结鞍区脑膜瘤的临床特征、影像学特征、显微手术入路的选择.分别对可能影响患者术后视力恢复的因素进行非参数检验单因素分析和Logistic回归多因素分析.结果经单因素分析,影响术后视力恢复的因素有:术前视力障碍持续时间(P=0.001)、术前视力障碍程度(P=0.001)、术前眼底改变(P=0.001)、术前视觉诱发电位波幅改变(P=0.001)、肿瘤基底(P =0.006)、肿瘤质地(P =0.002)、肿瘤生长方向(P =0.003)、肿瘤与视神经的关系(P=0.001)、术中视神经的形态(P =0.001)、肿瘤与颈内动脉及其分支的关系(P=0.038).经多因素Logistic回归分析发现,术前视力障碍程度(P =0.001)、术前眼底改变(P =0.019)、术前视觉诱发电位波幅改变(P=0.009)以及肿瘤与视神经的的关系(P=0.012)是影响术后视力恢复的显著因素.结论鞍区脑膜瘤应早期诊断、早期治疗,术前视力障碍程度、术前眼底改变、术前视觉诱发电位波幅改变以及肿瘤与视神经的的关系是影响术后视力恢复的重要因素.
목적 총결안구뇌막류적림상특정、영상학특정、현미수술입로적선택,병탐토영향환자술후시력회복적인소.방법 회고성분석44례안구뇌막류환자적림상자료병대기진행수방연구,총결안구뇌막류적림상특정、영상학특정、현미수술입로적선택.분별대가능영향환자술후시력회복적인소진행비삼수검험단인소분석화Logistic회귀다인소분석.결과 경단인소분석,영향술후시력회복적인소유:술전시력장애지속시간(P=0.001)、술전시력장애정도(P=0.001)、술전안저개변(P=0.001)、술전시각유발전위파폭개변(P=0.001)、종류기저(P =0.006)、종류질지(P =0.002)、종류생장방향(P =0.003)、종류여시신경적관계(P=0.001)、술중시신경적형태(P =0.001)、종류여경내동맥급기분지적관계(P=0.038).경다인소Logistic회귀분석발현,술전시력장애정도(P =0.001)、술전안저개변(P =0.019)、술전시각유발전위파폭개변(P=0.009)이급종류여시신경적적관계(P=0.012)시영향술후시력회복적현저인소.결론 안구뇌막류응조기진단、조기치료,술전시력장애정도、술전안저개변、술전시각유발전위파폭개변이급종류여시신경적적관계시영향술후시력회복적중요인소.
Objectives To summarize the clinical features, imaging features and the selection of microscopic surgical approaches and to investigate the factors of affecting postoperative visual acuity recovery of patients.Methods The clinical data of 44 patients with sellar meningiomas were analyzed retrospectively and the follow-up study was performed.The clinical features, imaging features, and selection of microsurgical approach were summarized.The factors that might affect the recovery of visual acuity in patients after procedure were analyzed respectively with the univariate analysis of non-parametric tests and logistic regression multivariate analysis.Results After univariate analysis, the factors of affecting visual acuity are as follows: duration of preoperative visual impairment (P =0.001) , degree of preoperative visual impairment (P =0.001), preoperative fundus change (P =0.001), preoperative visual evoked potential amplitude change (P =0.001), tumor base (P =0.006), tumor texture (P--O.002), tumor growth direction (P =0.003), relationship between tumors and optic nerves (P =0.001), optic nerve morphology in surgery (P =0.001), and relationship between tumors and internal carotid artery and its branches (P =0.038).Multivariate logistic regression analysis found that the degree of preoperative visual impairment (P--0.001) , preoperative fundus change (P =0.019), preoperative visual evoked potential amplitude change (P-0.009), and relationship between tumors and optic nerves (P =0.012) were the significant factors for affecting postoperative visual acuity recovery.Conclusions Sellar meningiomas should be diagnosed and treated early.The degree of preoperative visual impairment, preoperative fundus change, preoperative visual evoked potential amplitude change and relationship between tumors and optic nerves are the key factors for affecting postoperative visual acuity recovery.