垂体脓肿8例临床分析

目的探讨垂体脓肿的临床特征和治疗.方法回顾性分析8例垂体脓肿患者的临床表现、影像学特征、诊断和治疗,并结合文献进行分析.结果8例患者中仅1例有明显颅内感染征象,视力视野障碍者5例,尿崩者4例,垂体功能低下者4例,影像学常无特征性改变.4例经开颅手术,4例经蝶手术治疗.术后随访5例患者中4例脓肿无复发,视力视野改善者2例,尿崩者2例恢复正常,垂体功能低下者随访2例患者中1例恢复正常,1例经翼点入路手术者脓肿复发.结论垂体脓肿术前诊断困难,对鞍区囊性病变应考虑到垂体脓肿的可能,及早手术、正确地选择手术入路、合理应用抗生素和适当的对症治疗是治疗垂体脓肿的关键.

Pituitary abscess:clinical analysis of eight cases

Objective To explore clinical features and treatments of pituitary abscess. Methods A retrospective analysis was done upon clinical presentations,imaging features, diagnosis and treatment in 8 cases of pituitary abscess. Results Of 8 cases,meningitis was present in 1 case, visual disturbance in 5 cases,diabetes insipidus in 4 cases,and hypopituiarism in 4 cases. Imaging feature was not special. All cases were treated surgically, 4 by craniectomy and 4 by transsphenoidal approach. Postoperatively,5 cases were followed up. Visual disturbance in 2 cases was improved and hypopituitarism in 1 cases and diabetes insipdus in 2 cases were recovered. One case via the pteroidal approach relapsed. Conclusions The diagnosis of pituitary abscess was difficult before operation. Pituitary cystoid focus should be considered the possibility of pituitary abscess. Appropriate surgical approach, proper antibiotics and symptomatic therapy were the keys to treatment of pituitary abscess.