垂体瘤病人的临床表现及诊断延迟分析（附81例分析）

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1、垂体瘤病人的临床表现及诊断延迟分析(附81例分析)作者：王集生单位：首都医科大学附属北京天坛医院神经外3科，北京100050【摘要】目的分析垂体瘤的临床特征和诊疗情况。方法对81例垂体瘤病人的临床资料和诊断经过进行冋顾性研究。结果视力、视野损害，月经紊乱，头痛和肢端肥大是垂体瘤最主要的首发症状，占85.2%(69例)；木组病人发病至就诊延谋平均吋间为17.6个月，其中以视力、视野损害而就诊的病人延误时间最短，而以肢端肥人就诊的病人延误吋间最长；病人首诊于眼科者达到半数，其次为妇产科；首诊至确诊吋间

2、在眼科为(12.7±3.7)个月，普通内科为(30.6&plusnw;9.6)个月，其诊断正确率分别为55.0%和11.2%。结论垂体瘤故常见的临床表现为视力、视野损害，常首诊于眼科、妇产科或内科；掌握相关专业的临床知识，完善有关检查可减少和避免误诊。【关键词】垂体肿瘤体征和症状诊断Clinicalfeaturesanddiagnosisofpituitaryadenomain81casesWANGJishengl,GUORuizhong2,JINani1.DepartmentofN

3、eurosurgery,TiantanHospital,CapitalUniversityofMedicalSciences,Beijing100050,China;2.DepartmentofNeurosurgery,LinfenPeople'sHospital,Linfen041000,ChinaAbstract:ObjectiveToexploreclinicalfeaturesanddiagnosticprocedureofpituitaryadenoma.MethodsClinicald

4、ataanddiagnosticprocedureof81patientswithpituitaryadenomawereanalyzed・ResultsImpairmentofvisionand/orvisualfield,menstrualdisorder,headacheandacromegalymadeup85.2%(69cases)ofthefirstsymptoms.Theaveragetimefromoccurrenceofclinicalsymptomstoadmissionwas

5、17.6months.Inthegroup,thedelayedtimewastheshortestinpatientswithdamageofvisionandvisualfieldasthefirstpresentation,andthelongestwithacromegaly.Almosthalfofthepatientswerefirstadmittedinthedepartmentofophthalmology,andthenthedepartmentofgynaecologyando

6、bstetrics・Thetimebetweeninitialdiagnosisanddefinitediagnosiswas12.7±3・7monthsinophthalmology,whileitwas30.6±9.6monthsinthedepartmentofinternalmedicine,andthediagnosticaccuracyrateinthetwodepartmentswas55.0%and11.2%respectively.Conclusion

7、Themostfrequentclinicalmanifestationofthepituitaryadenomaisvisionand/orvisualfielddysfunction,andthepatientsoftenfirstvisitdepartmentsofophthalmology,gynaecologyandobstetricsandinternalmedicine.Doctorsinthesedepartmentsshouldintegratemoreknowledgeonth

8、eclinicalfeaturesanddiagnosisofsellarlesionstoavoidthemisdiagnosis・Keywords:pituitaryneoplasms;signsandsymptoms;diagnosis2005年8月~2007年3月，我科收治89例垂体瘤病人，其中81例排除眼科疾病和其他共患肿瘤，现对该81例的临床表现和诊疗过程进行分析，报告如下。1对象与方法男41例，女40例。年龄15-77岁，平均(44.7±13.5)岁。统