以情绪低落症状起病的松果体肿瘤术后梗阻性脑积水1例  

A case of postoperative obstructive hydrocephalus after pinealoma surgery onset with depressive symptoms

作　　者：王媺媞 汪崇泽[1] 周霓 陈宇鹏 陶英华 王芳 吕钦谕 洪武[1] Wang Meiti;Wang Chongze;Zhou Ni;Chen Yupeng;Tao Yinghua;Wang Fang;Lyu Qinyu;Hong Wu(Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,Shanghai 201100,China;Department of Medical Psychology,Shanghai Seventh People′s Hospital,Shanghai 200137,China;Department of Psychology,Children′s Hospital of Fudan University,Shanghai 201102,China)

机构地区：[1]上海交通大学医学院附属精神卫生中心,上海201100 [2]上海市第七人民医院医学心理科,上海200137 [3]复旦大学附属儿科医院心理科,上海201102

出　　处：《中华精神科杂志》2023年第6期453-456,共4页Chinese Journal of Psychiatry

基　　金：上海市精神卫生中心面上项目(2021-YJ-02);上海市“科技创新行动计划”医学创新研究专项(21Y11905600);上海市“科技创新行动计划”自然科学基金项目(21ZR1455100);上海交通大学医学院科技创新项目(人文社科类)(WK2017)。

摘　　要：松果体肿瘤(pinealoma)因其特殊的位置类型,常伴有梗阻性脑积水,在手术切除的同时需联合脑室-腹腔分流术(ventriculoperitoneal shunt,VPS)进行治疗。而分流管堵塞导致分流失败是最常见的术后并发症。本文通过报道1例联合行松果体肿瘤切除术及脑室-腹腔分流术后因分流管堵塞导致梗阻性脑积水(obstructive hydrocephalus),以情绪低落、兴趣下降、精力减退为起始症状,逐渐出现少吃、少语、少动亚木僵表现而反复就诊精神科且经多种抗抑郁药治疗无效的患者,以期提高临床医生对这类症状复杂多变、容易误诊误用精神科药物的疾病的认识。Pinealoma often comorbid with obstructive hydrocephalus due to their specific location and type,therefore,patients with pinealoma need to be treated by a combined ventriculoperitoneal shunt(VPS)along with surgical resection.Shunt failure is the most common complication after surgery.In this paper,we report a case of obstructive hydrocephalus caused by shunt obstruction after pineal gland tumor resection combined with ventriculoperitoneal shunt.The patient first showed low mood,decreased interest and energy,and gradually developed into manifestations of less eating,less talking,less movement,repeated psychiatric visits,and showed no improvement after treatment with antidepressants.The purpose of the current study is to increase the knowledge of these diseases and reduce misdiagnosis.

关 键 词：松果体瘤 器质性心境障碍 梗阻性脑积水 

分 类 号：R739.4[医药卫生—肿瘤]