垂体脓肿的临床特征和经蝶窦手术治疗

目的 分析垂体脓肿的临床特征和经蝶窦手术治疗。方法 12例垂体脓肿的术前症状依次为尿崩症、头痛、垂体功能低下和视功能障碍。MRI显示垂体类圆形肿物。均经蝶窦入路显微外科手术清除脓肿，反复冲洗和放置引流。结果 随诊1～10年。头痛缓解为71％(5／7)，视功能改善80％(4／5)，尿崩症缓解63％(5／8)，垂体功能低下改善50％(3／6)。结论 当MRI显示垂体肿物的病人出现严重的尿崩症和垂体功能低下时，应考虑到垂体脓肿。怀疑为垂体脓肿者应及时经蝶窦术清除脓肿和引流。

Clinical Characteristics and Transsphenoidal Microneurosurgery of Pituitary Abscess

Objective To analyze the clinical characteristics and transsphenoidal microsurgery of pituitary abscess. Methods The data of 12 patients with pituitary abscess proved by operation were analyzed retrospectively. Preoperative clinical symptoms included diabetes inspidus, headache, hypopituitarism and visual dysfunction. MRI showed that pituitary lesion was a round mass in the patients with pituitary abscess. The pituitary abscess were removed and drained by transsphenoidal microsurgery in 12 patients. Results The patients were postoperatively followed up from 1 to 10 years. The relief rate of diabetes inspidus was 63% (5/8), headache 71% (5/7), hypopituitism 50% (3/6) and visual dysfunction 80% (4/5). Conclusions Pituitary abscess should be considered in the patients in whom there were diabetes inspidus and hypopituitism, and the round pituitary mass is showed on MRI. The pituitary abscess should be removed and drained as early as possible by transsphenoidal microsurgery.