垂体脓肿的诊断与治疗

目的 探讨垂体脓肿的临床特点、诊断和治疗.方法 回顾性分析15例垂体脓肿患者的临床表现、影像学特征、诊断和治疗.结果 15例垂体脓肿术前误诊13例,9例经鼻蝶窦入路,2例经额下入路后改为经鼻蝶窦入路,4例行额下入路.15例患者术后均恢复良好,随诊未见复发.结论 早期出现视力和视野改变、尿崩和环形强化的鞍区囊性病灶应首先怀疑垂体脓肿,早诊断,合理应用抗生素,正确选择手术入路,及时手术治疗是改善预后的关键.

Diagnosis and treatment of pituitary abscess

Objective To investigate the clinical characteristics,diagnosis and treatment of pituitary abscess. Method 15 patients with pituitary abscess were retrospective analysised with their signs and symptoms,radiological characteristics, diagnosises and treatments. Results In 15 cases, 13 cases were misdiagnosed before operative, 9 choosed transsphenoidal approach, 4 transfrontal approach, 2 changed to transsphenoidal approach after transfrontal approach. Good prognosises without recurrence were achieved in all patients. Conclusions Patient with early change in visual field and eyesight, diabetes insipidus and sellar cystic mass with thicken rim enhanced should be first diagnosis pituitary abscess. Early right diagnosis,reasonable use of antibiotics and surgical approach and the right time to operate are necessary to improving prognosis.