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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。
Objective To investigate the clinical features and treatment of pituitary abscess. Methods Retrospective analysis of 8 cases of pituitary abscess in patients with clinical manifestations, imaging features, diagnosis and treatment, combined with the literature for analysis. Results Only one of the 8 patients had obvious signs of intracranial infection. Among them, 5 were visual impairment, 4 were diabetes insipidus, and 4 were hypopituitarism. Radiographic features often did not change. 4 cases underwent craniotomy and 4 cases underwent transsphenoidal surgery. All the 5 patients were followed up for 4 cases of abscess without recurrence, 2 cases of visual field improvement, 2 cases of diabetes insipidus returned to normal, 1 case of pituitary dysfunction in 2 cases returned to normal, 1 case by pterional approach Abscess recurrence. Conclusions Preoperative diagnosis of pituitary abscess is difficult, and the possibility of pituitary abscess should be considered in the cystic lesions of the sellar region. It is necessary to take early surgery and choose the appropriate surgical approach. Rational use of antibiotics and proper symptomatic treatment are the keys to the treatment of pituitary abscess.