急性垂体瘤卒中的临床分析

Clinical analysis of acute pituitary apoplexy

目的研究急性垂体瘤卒中的临床特点、治疗与预后。方法回顾性分析82例急性垂体瘤卒中病人的临床资料,均采用手术治疗。根据垂体瘤卒中后手术时间,早期手术（≤7 d）28例,晚期手术（7~14 d）54例。结果男性病例多于女性,与同期非卒中病人相比,性别差异显著（P〈0.05）。平均年龄为（49.6±13.7）岁,与同期非卒中病人比较无显著差异（P〉0.05）。病理类型以无功能型垂体腺瘤所占比例最大（41.5%）,其次为促性腺激素型（32.9%）,促甲状腺激素型所占比例最小（1.2%）。早期手术病人视力恢复程度优于晚期手术病人,差异具有统计学意义（P〈0.05）。结论急性垂体瘤卒中可能好发于50岁左右中年男性,有典型临床症状,病理类型以无功能型垂体腺瘤所占比例最大。早期手术减压,可解除对视神经的压迫,促进视力恢复。

Objective To study clinical features, treatment and prognosis of acute pituitary apoplexy due to adenoma. Methods The clinical data of 82 patients with acute pituitary apoplexy undergoing surgical treatment were analyzed retrospectively. According to the time after pituitary apoplexy, early operation（≤7 d） was performed in 28 cases and late operation（7-14 d） in 54 cases. Results Male patients were more than female patients, and there was a significant gender difference（P〈0.05） between patients with acute pituitary apoplexy and those with non-acute pituitary apoplexy during the same period. The average age was（49.6 ± 13.7） years, and there was no significant difference（P〉0.05） between patients with acute pituitary apoplexy and those with non-acute pituitary apoplexy during the same period. For pathological type, the proportion of non-functioning pituitary adenoma was the largest（ 41. 5 %）, followed by gonadotroph adenoma（32.9%）, and the proportion of thyroid-stimulating adenoma was the smallest（1.2%）. The recovery of visual acuity was better in the early surgery patients than in the late surgery patients, and the difference was statistically significant（P 〈0.05）.Conclutions Acute pituitary apoplexy usually occurs in middle-aged men around the age of 50 years with typical clinical symptoms. For pathological types, the proportion of non-functioning pituitary adenoma may be the largest. Early surgical decompression should be taken for patients with acute pituitary apoplexy due to adenoma because it can decompress the optic nerve and promote recovery of visual acuity.