摘要
厌色性垂体腺瘤手术治疗的目的是解除视神经交叉的压迫以改善视力。对手术治疗时机的选择,文献中有许多争论[1]。本文的目的是通过总结华山医院自1954年11月至1977年3月经手术证实的305例厌色性垂体腺瘤的手术疗效.
Three hundred and five consecutive cases of pituitary chromophobe adenoma that had been operated and verified pathologically during the period from November 1954 to March 1977,were analyzed in respect to their visual function before and after operation,to study retropeotivdly the validity of the operation.The main aim of operation was to relieve the compression of optic nerve and optic chiasma caused by the pituitary tumor.Postoperatively,the immediate results gave an improvement of visual acuity in 62.2%and improvement of visual field in 58.3%.Suggestion proposed that the recovery rate had a definite relationship to the degree of impairment of visual acuity and visual field,to the duration of compression to the optic nerve and to the degree of atrophy of the optic disc.In other words,the less impairment of visual acuity and visual field,immediately prior to the operation,the higher would be the postoperative recovery rate.This statement was further substantiated by the following facts:(1)In cases with severe impairment in visual acuity and in visual field preoperatively,the recovery,if it should occur at all after operation,would not eventually reach to a useful degree.(2)In cases with very severe impairment of visual acuity before operation,the least trauma imflicted during operation or pneumoencephalography might be enough to cause total loss of sight,(3)In all of the 6 eyes in which visual acuity was fully recovered and in all of the 13 eyes in which visual field was fully restored,the change of optic fundus was slight and the duration of compression to the optic nerve was relatively short before of operation.This illustrated that early diagnosis and early treatment were the key problems in order to expect a better result.The time of surgical interference of our cases might be too late according to our previous indications.We held that operation should be done as an elective one as soon as the diagnosis had been settled regardless how the visual acuity and how the visual field was.
出处
《上海医科大学学报》
1980年第1期44-50,共7页
Journal of Fudan University(Medical Science)
