鞍区肿瘤患者的视野情况分析

目的:分析鞍区肿瘤患者的视野情况。方法:汇总2008-08/2012-08于我科就诊的鞍区肿瘤患者的视野情况,并对资料进行分析。结果:鞍区肿瘤患者27例中,视野异常者16例(59.3%),视野正常者11例(40.7%)。16例视野发生改变的患者中,8例垂体瘤、3例颅咽管瘤和1例第三脑室恶性畸胎瘤均引起双眼颞侧偏盲,1例垂体瘤、1例垂体癌和1例颅咽管瘤引起单眼颞侧偏盲,1例鞍旁囊肿引起单眼颞上象限视野缺损。手术切除肿瘤后,13例(81.3%)患者的视野有改善,其中6例(37.5%)患者的视野完全恢复正常。结论:绝大多数鞍区肿瘤可引起视野的改变,但视野的具体形态由病灶的类型、大小和压迫部位决定。鞍区肿瘤引起的最典型视野改变为双颞侧偏盲。手术切除肿瘤后,绝大多数患者的视野得到改善,其中部分患者的视野完全恢复。因而,对鞍区肿瘤患者而言,视野检查有助于早期发现和辅助定位肿瘤,并且可以用来评价手术效果,从而为临床工作带来重要指导意义。

Vision field analysis of patients with sellar tumors

AIM: To summarize and analyze the vision field of patients with sellar tumors in our department in the recent 4 years.

METHODS: Vision field data of patients with sellar tumors from August 2008 to August 2012 were collected and analyzed.

RESULTS: Among 27 patients, 16 patients(59.3%)were with abnormal vision field, and 11 patients(40.7%)were with normal vision field. In 16 cases with abnormal vision field, 12 cases(75.0%, 8 cases with pituitary tumors, 3 cases with craniopharyngioma and 1 case with third ventricular malignant teratoma)were with bilateral temporal hemianopsia, 3 cases(18.8%, 1 case with pituitary tumors, 1 case with pituitary cancer and 1 case with craniopharyngioma)were with unilateral temporal hemianopsia, and 1 case with parasellar cyst(4.5%)was with unilateral superior-temporal hemianopsia. After excision of tumors, 13 cases(81.3%)had better vision field, and 6 cases(37.5%)recovered to normal.

CONCLUSION: Most sellar tumors can cause the change of vision field, and the vision field shape depends on the lesion type, size and pressed location. The most characterized vision field is bilateral temporal hemianopsia. After removing tumors, most patients can get better vision field, and some patients can recover to normal. Vision field examination is helpful in the early detection and location detection for sellar tumors, and it can also evaluate the surgery effects, which has guiding significance in the clinical working.