内镜经蝶手术治疗鞍区病变的视力保护简

目的探讨内镜经蝶手术治疗伴视觉障碍鞍区病变的手术操作技巧，提高治疗视觉障碍的疗效。方法回顾性分析68例内镜经蝶手术治疗伴视觉障碍鞍区病变病人的临床资料，分析术前病人的病史、体征和影像学资料，术中操作技巧和所见鞍膈形态。及术后视觉障碍改善情况。结果肿瘤全切除60例，次全切除8例。随访6-36个月，术前病人视力下降、视野缺损者，术后1个月均基本恢复；未发现肿瘤复发。结论对鞍区病变的视力保护，术前预估鞍膈的病理形态非常重要，术中避免直接对视神经及血管结构的操作，可减少手术并发症，促进病人视觉障碍恢复。

Protective measure of visual acuity in endoscopic transsphenoidal surgery for sellar lesions

Objective To explore the surgical technique in endoscopic transsphenoidal surgery for sellar lesions with visual disturbance for improving the therapeutic efficacy. Methods Clinical data of 68 patients undergoing endoscopic transsphenoidal surgery for sellar lesions and visual disturbance were analyzed retrospectively, including medical history, physical sign and imaging data before the operation, surgical technique and the morphology of the diaphragma sellae during the operation, and postoperative visual outcome. Results Total tumor removal was achieved in 60 patients and subtotal removal in 8. During a follow-up period of 6 to 36 months, all visual disturbances obtained satisfactory outcome 1 month after surgery and no patients recurred. Conclusion The preoperative assessment of pathological morphology of the diaphragma sella is very important for protecting vision in sellar lesion, and avoiding operation on neurovascular structures can decrease the surgical complications and promote the recovery of visual disturbance.