早期手术与在脑垂体神经内分泌瘤中改善术后视觉结果有关,而视觉急性恶化则伴有急性视觉恶化
Abhijit Goyal-Honavar1, Subhas Konar2, Nishanth Sadashiva1
1Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, 560029, Karnataka, India.
Neurosurgical review
|February 27, 2025
概括
催促性手术减压用于垂体脑可以改善大多数患者的视力. 当手术发生在一周内时,可以看到最佳的视力恢复,但在完全失明的情况下不会出现.
科学领域:
- 神经外科 神经外科
- 眼科医生 眼科 眼科
- 内分泌学 在内分泌学.
背景情况:
- 垂体脑梗塞是一种关键的神经外科疾病,导致视力丧失和神经问题.
- 迅速的手术减压通常是必要的,但最佳时间和影响视觉恢复的因素尚不清楚.
研究的目的:
- 为了评估手术时间和患者特征在垂体瘤手术后对视觉结果的影响.
- 为了确定视觉改善的预测因子,在下垂体中风的手术减压后.
主要方法:
- 追溯分析55名患有垂体脑卒中和急性视力恶化而接受手术的患者 (2013-2023年).
- 收集的数据包括临床表现,手术方法 (内镜/透镜/显微镜),以及术后视力敏度 (VA) 和视野演变.
- 在VA改善和没有VA改善的患者之间比较了术后因素.
主要成果:
- 总体而言,75%的患者经历了VA改善,63.4%的患者表现出显著改善.
- 预测VA结果差的因素包括对光负视力的感知,视力恶化超过168小时,以及神经.
- 透视透视手术是最常见的方法 (80%).
结论:
- 对于垂体中风的手术减压通常会使大多数患者的视力得到改善.
- 视力发作后96小时至一周内进行手术似乎是有益的,而先前存在的失明与较差的结果有关.
- 识别不改善的预测因素对于管理患者的期望和优化治疗策略至关重要.
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