垂体腺瘤术后垂体脓肿的诊治

Diagnosis and management of pituitary abscess after pituitary tumor surgery

目的探讨经蝶垂体腺瘤术后垂体脓肿的临床特征和诊治。方法回顾性分析2例经蝶垂体腺瘤术后垂体脓肿病人的临床资料，1例因脓液溃破入颅内，急诊行开颅手术清除脓液；1例行抗生素保守治疗。结果2例病人治疗后均恢复良好，未遗留明显神经功能障碍。术后随访6-9个月，均未发现脓肿复发。结论及早诊断和治疗是挽救垂体脓肿病人生命的保障。一经诊断，应及时经蝶开窗引流；发生脓液破入颅内，应立即开颅手术。

Objective To explore clinical characteristics and management of pituitary abscess after pituitary tumor surgery. Methods Clinical data of 2 patients with pituitary abscess after pituitary tumor surgery were analyzed retrospectively. An emergency craniotomy was performed to remove and drain pus for the patient with ruptured abscess. Another patient was treated with antibiotics. Results The two patients recovered well without significant nerve dysfunction after treatment, and no abscess recurred during the follow-up period of 6 to 9 months. Conclusions Early diagnosis and treatment is essential to rescue the patients with pituitary abscess. Transsphenoidal surgery for drainage should be performed as soon as possible when the diagnosis is defined. An emergency craniotomy should be carried out if the pus breaks into intracranial cavity.