垂体腺瘤相关动眼神经麻痹发生与恢复时间的影响因素分析  

Influencing factors of occurrence and recovery time of ONP associated with pituitary adenoma

作　　者：李仁涛 戚其超 王茂波[3] 倪石磊[2] LI Rentao;QI Qichao;WANG Maobo;NI Shilei(Qilu Hospital,Cheeloo College of Medicine,Shandong University,Jinan 250012,China;不详)

机构地区：[1]山东大学齐鲁医学院齐鲁医院,济南250012 [2]山东大学齐鲁医院神经外科 [3]山东大学附属山东省妇幼保健院放射科

出　　处：《山东医药》2021年第21期27-30,共4页Shandong Medical Journal

摘　　要：目的总结垂体腺瘤相关动眼神经麻痹发生及恢复时间的影响因素。方法20例垂体腺瘤并发动眼神经麻痹患者作为观察组,15例垂体腺瘤不并发动眼神经麻痹的患者作为对照组。收集两组患者性别、年龄、并发症(并发头疼、并发视力改变、并发视野改变、并发卒中)、肿瘤是否有分泌功能、肿瘤侵袭程度(采用Hardy-Wilson和Knosp分级标准)、肿瘤是否同时侵犯海绵窦上区和外侧区、肿瘤最大直径等临床资料,单因素分析垂体腺瘤相关动眼神经麻痹发生的可能影响因素;将单因素分析有统计学差异的指标为自变量,采用多因素Logistic回归分析法分析垂体腺瘤相关动眼神经麻痹发生的独立影响因素。收集观察组患者性别、年龄、并发卒中、动眼神经麻痹程度、入院前动眼神经麻痹时间、是否接受手术、肿瘤侵袭程度(采用Hardy-Wilson和Knosp分级标准)、肿瘤是否同时侵犯海绵窦上区和外侧区、肿瘤最大直径等临床资料并进行赋值,采用单因素和多因素COX回归分析法分析垂体腺瘤相关动眼神经麻痹恢复时间的影响因素。结果观察组并发卒中、肿瘤同时侵犯海绵窦上区和外侧区、肿瘤无分泌功能、Knosp分级3~4级等资料与对照组相比,P均<0.05;但并发卒中、肿瘤同时侵犯海绵窦上区和外侧区、肿瘤无分泌功能、Knosp分级3~4级均不是垂体腺瘤相关动眼神经麻痹发生的独立影响因素(P均>0.05)。年龄>60岁(HR=0.202,95%CI=0.063~0.645,P<0.01)可能是垂体腺瘤相关动眼神经麻痹恢复时间的危险因素,但不是独立危险因素(P>0.05)。结论垂体腺瘤合并卒中、肿瘤同时侵犯海绵窦上区和外侧区、肿瘤无分泌功能、患侧Knosp分级3~4级可能是垂体腺瘤相关动眼神经麻痹发生的影响因素,但均不是独立影响因素;年龄>60岁可能是垂体腺瘤相关动眼神经麻痹恢复时间的危险因素,但不是独立危险因素。Objective To summarize the influencing factors of occurrence and recovery time of oculomotor nerve pal-sy(ONP)associated with pituitary adenoma.Methods Twenty cases of pituitary adenoma patients complicated with ONP were taken as the observation group and 15 cases of pituitary adenomas patients without ONP were taken as the con-trol group.The following clinical data of patients in two groups were collected:gender,age,complications(headache,changes of eyesight and visual field,and stroke),whether the tumors had the secretory function or not,the aggregated de-gree of tumors(Hardy-Wilson degree and Knosp degree),tumors invaded superior and lateral cavernous sinus at the same time or not,and the maximum tumor diameter.The indexes with statistical difference in univariate analysis were regarded as independent variables,and multivariate logistic regression analysis was used to detect the independent factors of the oc-currence of ONP associated with pituitary adenoma.Clinical information of patients in observation group such as gender,age,stroke,the degree of ONP,the last time of ONP before treating,accepted surgery or not,the aggregated degree of tu-mors(Hardy-Wilson degree and Knosp degree),the tumors invaded superior and lateral cavernous sinus at the same time or not and the maximum tumor diameter were collected and valued.Univariate and multivariate COX regression analyses were applied to analyze the influencing factors of recovery time of pituitary adenoma related ONP.Results Compared with control group,pituitary adenoma combined with stroke,tumors invaded both superior and lateral cavernous sinus at the same time,tumors without the secretory function,and Knosp grade 3-4 in observation group,(all P<0.05).Pituitary adenoma combined with stroke,tumors invaded superior and lateral cavernous sinus at the same time,tumors without the secretory function and Knosp grade 3-4 were not independent influencing factors for the occurence of ONP associated with pituitary adenoma(all P>0.05).Age>60(HR=0.202,95%CI=0.063-0.645,P<0

关 键 词：颅神经麻痹 动眼神经麻痹 垂体腺瘤并发症 视力障碍 卒中 年龄 

分 类 号：R736.4[医药卫生—肿瘤]