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目的:探讨垂体腺瘤的眼部临床表现和主要诊断依据,为临床早期诊断和预后判断提供依据,以减少误诊率。方法:对32例垂体腺瘤患者进行病例回顾性分析。其中男11例,女21例。年龄25~55(平均41)岁,伴内分泌紊乱的8例,肿瘤部位:右眼19例,左眼13例。病理诊断示:嫌色性腺瘤20例,嗜酸性腺瘤4例,嗜碱性腺瘤2例,混合性腺瘤6例。均转入颅脑外科手术治疗。结果:术后观察:单眼光感4例,0.1~0.2者4例,0.3~0.9者24例。单眼原发性视神经萎缩5例,未见好转。32例中有4例,视野无改变(单眼光感、视野无法检查),28例视野均有明显改善。结论:垂体腺瘤的眼部症状常为临床上首发和最重要的改变,极易误诊,因此要求眼科医生需具备一定的神经眼科知识,并通过多学科合作,及时挽救脑肿瘤等疑难重症患者。
Objective: To investigate the clinical manifestations and the main diagnostic criteria of pituitary adenomas for early diagnosis and prognosis to reduce the misdiagnosis rate. Methods: 32 cases of pituitary adenomas were retrospectively analyzed. Including 11 males and 21 females. Age 25 ~ 55 (average 41) years, with endocrine disorders in 8 cases, tumor sites: 19 cases of right eye and left eye in 13 cases. Pathological diagnosis showed: 20 cases of chromophobe adenoma, 4 cases of acidophilic adenoma, basophilic adenoma in 2 cases, mixed adenoma in 6 cases. Are transferred to brain surgery. Results: Postoperative observation: monocular light perception in 4 cases, 0.1 to 0.2 in 4 cases, 0.3 to 0.9 in 24 cases. Primary monocular optic atrophy in 5 cases, no improvement. In 32 cases, there were 4 cases with no change of visual field (monocular light perception and visual field could not be inspected), and 28 cases had obvious visual field improvement. Conclusion: The ocular symptoms of pituitary adenoma are often the first and most important clinical changes and are easily misdiagnosed. Therefore, ophthalmologists are required to have some knowledge of neuro-ophthalmology and timely rescue the patients with difficult-to-treat brain tumors through multidisciplinary cooperation .