鞍区占位性病变的临床表现及诊断分析

Clinical feature and diagnosis of sellar region lesions

目的分析鞍区占位性病变的临床特征和诊疗情况。方法对101例鞍区占位患者的临床资料和诊断经过进行回顾性研究。结果视力、视野损害,月经紊乱,头痛和肢端肥大是鞍区占位最主要的首发症状,占总数的86.1%;患者中首诊于眼科者占首位(50例),其次为妇产科;首诊至确诊时间平均(12.8±20.7)个月,但内科平均(29.3±8.7)个月,且诊断正确率仅为10%;本组患者发病至就诊平均延误长达(16.1±27.4)个月,存在视力、视野损害者就诊延误时间最短(6.7±1.7)个月,而生长素型垂体瘤导致的肢端肥大就诊延迟时间最长,(45.5±13.0)个月。结论鞍区占位性病变最常见的临床表现为视力、视野损害,常首诊于眼科、妇产科或内分泌科,掌握丰富的相关知识、完善有关检查可减少和避免误诊。

Objective To explore clinical features and diagnostic procedure of sellar region lesions. Methods 101 patients with sellar lesions were analyzed retrospectively with their clinical information. Results Impairment of vision or visual field, menstrual disorder, headache and acromegaly made up 86.1% of the first symptoms; 49.5% patients were first admitted in the department of ophthalmology and 11.9% in the department of gynecology; it took （12.8±20.7） months in average to make the final diagnosis, it was （12.6±3.1） months in ophthalmology, （29.3±8.7） months in the department of internal medicine： we found a （16.1±27.4） months＇ delay between occurrence of clinical manifestation and admission, it was only （6.7±1.7） months delay in patients with vision or visual field impairment but （45.5±13.0） months delay in patients with acromegaly. Conclusions Physicians of ophthalmology, internal medicine and gynecology should handle more information about the clinical features and diagnosis of sellar lesions to avoid the misdiagnosis.