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目的总结临床所诊治的以视觉损伤为首发症状的10例中老年人无功能垂体腺瘤的临床特点和内镜下经蝶切除的疗效。方法收集经眼科视力、视野检查及CT检查确诊的10例中老年人无功能垂体腺瘤患者的临床资料,所有患者均在确诊后在一周内接受了内镜下经蝶手术切除,并经鼻科、眼科、内分泌科随访半年以上。结果发病一个月以内确诊的5例患者,术后1周视力恢复良好,视野也有明显恢复。发病半年以上,并被误诊漏诊、严重视觉受损的5例患者,术后1周无恢复表现;术后半年,有1例恢复至光感,其它4例仍无任何恢复。结论无功能腺瘤经常以视觉受损为首发症状,并且无明显的内分泌表现;在中老年人尤其容易误诊,应提高警惕。对于及时确诊的病例,内镜下经蝶手术疗效明显,并发症少,值得临床推广。
Objective To summarize the clinical features of 10 cases of non-functional pituitary adenoma with visual impairment as the first symptom and the efficacy of endoscopic transsphenoidal resection. Methods The clinical data of 10 cases of non-functional pituitary adenoma confirmed by ophthalmology, visual field examination and CT examination were collected. All patients underwent endoscopic transsphenoidal surgery within one week after diagnosis, Section, ophthalmology, endocrinology, follow-up more than six months. Results Five patients diagnosed within one month after onset showed good visual acuity after 1 week and significant visual field recovery. The incidence of more than six months, and was misdiagnosed missed diagnosis, severe visual impairment in 5 patients, no recovery after 1 week performance; six months after surgery, 1 returned to light perception, the other 4 patients still did not recover. Conclusion Non-functional adenomas often have visual impairment as the first symptom, and no obvious endocrine performance; in the elderly is particularly vulnerable to misdiagnosis, should be vigilant. For timely diagnosis of cases, endoscopic transsphenoidal surgery obvious effect, fewer complications, it is worth clinical promotion.