垂体脓肿临床特征分析  

Analysis of Clinical Features of Pituitary Abscess

作　　者：杨世华 李福依 王睿[1] 张丽侠[1] 李雪元 许莉军 YANG Shihua;LI Fuyi;WANG Rui;ZHANG Lixia;LI Xueyuan;XU Lijun(Department of Endocrinology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Neurosurgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院内分泌与代谢病科,河南郑州450052 [2]郑州大学第一附属医院神经外科,河南郑州450052

出　　处：《河南医学研究》2023年第21期3889-3895,共7页Henan Medical Research

基　　金：国家自然科学基金(U1904140)。

摘　　要：目的通过对垂体脓肿患者的临床特点进行总结分析,提高临床医生对该病的认识。方法对2019年1月至2021年12月于郑州大学第一附属医院住院治疗的垂体脓肿患者的临床表现、实验室检查、影像学特征、治疗方法及随访等临床资料进行总结分析,并对文献进行复习。结果共纳入4例垂体脓肿患者,均有头痛症状,其中垂体前叶功能减退2例、视力障碍2例、尿崩症1例、发热1例。影像学检查显示3例患者的垂体脓肿在增强磁共振成像(MRI)上表现出典型的环形边缘强化,1例未出现特征性环形强化。4例垂体脓肿患者中,2例术前分别误诊为垂体囊肿和垂体占位。4例患者均接受了经蝶窦手术,病理证实为垂体脓肿。术后随访0~3 a,2例有持续性垂体前叶功能减退,1例有持续性尿崩症,均需激素替代治疗。随访期间4例患者均无复发。结论垂体脓肿的发病率较低,临床表现与其他鞍区肿瘤不易鉴别,临床上易误诊。早期识别、准确诊断是垂体脓肿进一步有效治疗的关键。Objective To summary and analyze the clinical characteristics of patients with pituitary abscesses,so as to improve clinicians’understanding of the disease.Methods Clinical data such as clinical manifestations,laboratory examinations,imaging features,treatment methods and follow-up of patients with pituitary abscesses who were hospitalized in the First Affiliated Hospital of Zhengzhou University from January 2019 to December 2021 were collected and analyzed,and the literature was reviewed.Results A total of four patients with pituitary abscess were included,all had headache symptoms.Two patients had anterior pituitary hypofunction,two patients had visual impairment,one patient had diabetes insipidus,and one patient had fever.Imaging studies showed that pituitary abscesses in three patients showed typical annular edge enhancement on enhanced magnetic resonance imaging(MRI),and one patient had no characteristic annular enhancement.Among the four patients with pituitary abscess,two patients were misdiagnosed as pituitary cyst and pituitary space-occupying respectively before operation.All four patients underwent transsphenoidal surgery and were pathologically confirmed to pituitary abscesses.Follow-up for 0-3 years showed that two patients had persistent anterior pituitary hypofunction and one patient had persistent diabetes insipidus,all of which required hormone replacement therapy.During the follow-up period,all four patients had no recurrence.Conclusion The incidence of pituitary abscess is low,and its clinical manifestations are difficult to distinguish from other sellar tumors,and it is easy to be misdiagnosed clinically.Early identification and accurate diagnosis are the keys to further effective treatment of pituitary abscess.

关 键 词：垂体脓肿 早期诊断 治疗 

分 类 号：R584[医药卫生—内分泌]