垂体脓肿的临床特点及治疗分析  

Clinical features and treatment of pituitary abscess

作　　者：吴伟东 刘莹[2] 梁勇 WU Weidong;LIU Ying;LIANG Yong(Department of Neurosurgery,General Hospital of Northern Theater Command,Shenyang,Liaoning 110016,China;Department of Neurology,Shenyang Red Cross Hospital,Shenyang,Liaoning 110016,China)

机构地区：[1]中国人民解放军北部战区总医院神经外科,辽宁沈阳110000 [2]沈阳市红十字会医院神经内科,辽宁沈阳110000

出　　处：《中华神经外科疾病研究杂志》2024年第3期19-22,共4页Chinese Journal of Neurosurgical Disease Research

摘　　要：目的探讨垂体脓肿的临床特点和治疗方法。方法回顾性分析我院2019年1月至2022年3月诊治的原发性垂体脓肿患者10例,总结其临床特点、内分泌变化、影像学表现及治疗情况。结果共10例原发性垂体脓肿患者,其中男性患者2例,女性患者8例,平均年龄(44.6±15.0)岁;头痛起病有8例,出现视力下降或视野缺损的有7例,伴有多饮多尿有4例,甲状腺功能减退有3例,肾上腺皮质功能减退有5例,性腺功能减退症有7例。MRI典型表现为T1WI等或低信号有7例,T2WI高信号有6例,增强后表现为边缘环形强化有8例。1例细菌培养阳性;1例患者出现复发。结论头痛、垂体功能减退和视觉障碍是垂体脓肿最常见症状,典型MRI表现为T1加权像为低信号或等信号,T2加权像为高信号,增强后可见边缘强化。脓液培养阳性率低,连同脓肿壁送检细菌培养可能增加培养阳性率。经蝶窦入路术式具有更低的复发率,总体患者预后良好。Objective To investigate the clinical features and treatment of pituitary abscess.Methods Clinical data of 10 patients with pituitary abscess from January 2019 to March 2022 in our hospital were retrospectively analyzed,We summarize the clinical features,hormonal change,MR image features,and treatment of patients with pituitary abscesses.Results There were 10 patients with pituitary abscess,including 2 male patients and 8 female patients,with an average age of 44.6±15.0 years old,8 patients had headache onset,7 patients had vision defect,and 4 patients had diabetes insipidus.There were 3 cases of hypothyroidism,5 cases of adrenal insufficiency,and 7 cases of hypogonadism.Typical MR image features were hypointense signal on T1WI in 7 cases,hyperintensity on T2WI in 6 cases,and peripheral ring enhancement in 8 cases.Only 1 case of bacterial culture was positive,and 1 case had a recurrence.Conclusion Headache,hypopituitarism and visual defect are the most common symptoms of pituitary abscess.Typical MR image are hypointense on T1WI and hyperintensity on T2WI,and peripheral ring enhancement.The positive rate of culture is low,and a sample of the abscess wall is sent for culture might increase the chance of pathogen isolation.The treatment of pituitary abscess by transsphenoidal approach has a lower recurrence rate and usually patient have an good outcome.

关 键 词：垂体脓肿 临床特点 诊断 手术 

分 类 号：R651.1[医药卫生—外科学]