老年Sheehan综合征长期误诊临床研究

Clinical Study on the Long-term Misdiagnosis of Aged Sheehan′s Syndrome

目的 研究老年女性 Sheehan综合征的长期误诊原因 ,以提高早期诊治率。方法 老年 Sheehan综合征长期误诊 (误诊时间 15～ 36 a) 14例 ,对其易误诊疾病及常见误诊原因进行回顾性临床分析。结果 Sheehan综合征长期误诊率为 5 8% ,常见误诊疾病有神经衰弱 (71% )、慢性胃炎 (5 7% )、慢性肠炎 (43% )、精神障碍 (2 1% )等。结论 1无明显受器质性疾病所致的长期精神萎靡、体质衰弱以及持续低血压状态时 ,应常规进行内分泌激素的检测 ;2有产后出血病史 ,且出血量超过 5 0 0 m l,且伴有休克时 ,应考虑 Sheehan综合征发生的可能 ;3产后无泌乳即应检测垂体前叶及靶腺的激素 ;4产褥期预防感染性休克或 DIC的发生。

Objective To study the causes of Aged Sheehan′s syndrome with long term (15～36 years) misdiagnosis& to improve the correct diagnose rate in the early period of the disease.Methods Clinical data of 14 cases of Shenhan′s syndrome who were long term misdiagnosed as others diseases were analyzed retrospectively.Results Long term misdiagnosis rate of the aged Sheehan′s syndrome was 58%.Common misdiagnosed diseases were neurasthenia(71%),chronic gastritis (57%),chronic enteritis(43%),dysphrenia(21%) and so on.Conclusions ①Examing the endocritic hormones was routine when the patients had the symptome of unvigorous, weak constitution and low blood pressure without organic diseases;②We should consider the possibility of aged Sheehan′s syndrome when the patients bled more than 500 ml and had shock after childbirth;③Examing the hormones of pituitary gland and other target glands before lactation. ④Preventing infective shock or DIC during the period of puerperium.