目的 探讨改善侵犯视神经管的脑膜肿瘤术后视力水平的影响因素.方法 收集侵犯视神经管的脑膜肿瘤患者的临床资料,logistic回归分析性别、年龄、肿瘤大小、术前视力、肿瘤切除程度、肿瘤粘连周围结构程度、视神经管减压时机和患者视力转归的关系.结果 共55例,术后视力改善26例,无改善29例.早期硬膜外视神经管减压17例,视力好转15例;后期视神经管减压9例,视力好转5例;单纯刮除29例,视力好转6例.单因素分析提示切除级别、肿瘤粘连程度和早期硬膜外视神经管减压可影响术后视力改善;logistic回归分析显示早期硬膜外视神经管减压是改善术后视力的唯一保护因素.结论 对于术前考虑已经侵犯视神经管的鞍区脑膜肿瘤,术中宜行早期硬膜外视神经管减压以改善患者术后视力.%Objective To investigate the clinical factors which improved the postoperative vision in patients with meningeal tumor of sellar region invaded the optic canal. Methods Clinical data was collected from medical records of patient with meningeal tumors invaded optic canal from Jan. 2010 to Oct. 2016.A multiple factor analysis with logistic regression method was used to analyze these data. Results There were 55 cases included in the study. Vision was improved in 26 cases including 15 of 17 cases with early epidual optic canal decompression, 5 of 9 cases with Later optic canal decompression and 6 of 29 cases with curettage of optic canal tumor. A univariate analysis showed that resection grade,tumor adhesion and early epidural optic canal decompression were associated with visual improvement. Regression analysis showed that early epidural optic canal decompression was the only factor which could improve postoperative vision. Conclusion Early epidural optic canal decompression should be a good choice to improve the postoperative vision of meningeal tumors of sellar region invaded the optic canal.
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