Clinical Research Of Pituitary Apoplexy

Objective:The pituitary apoplexy paitient's age,sex,predisposing factors,clinical manifestations,clinical type,imaging features,tumor size,treatment methods and prognosis were analyzed,to provide reference for clinicians in the diagnosis and treatment of pituitary apoplexy.Methods:Collecting from January 2014 to January in the first Bethune hospital of Jilin University admitted 47 cases of pituitary apoplexy to analyze comprehensively the patient's sex,age,predisposing factors,clinical manifestations,clinical type,imaging features,tumor size,treatment methods and prognosis.Results:In the patients with pituitary adenoma apoplexy,43 cases of patients with transsphenoidal approach operation,2 cases of patients with transcranial approach operation,1 case of patients having elective transcranial approach operation after the transsphenoidal approach operation,1 case of patients with conservative treatment,cerebrospinal rhinorrhea was occurred in 2 transsphenoidal operative cases,2 cases cerebrospinal rhinorrhea's symptom disappeared after surgical repair.The main length of stay was 14 d,and the range of LOS was 3-33 d,All cases were evaluated by The GOS score when they discharged,the result suggested that 35 cases recovered well(5 points),8 cases with mild disability that visual field defects and decreased vision or monocular blind,but independent living(4 points),;2 cases with total blindness(3),2 cases died.The improvement of clinical symptoms of postoperative is listed as: there were 38 patients with different degrees of decreased vision,12 cases were obviously improved,11 cases recovory to normal;24 patients with varying degrees of visual field loss,including 15 cases had good recovery;4 patients with ophthalmoplegia,only 1 case didn't improve,the other 2 cases fully recovered to normal,1 case have partial recovery in the patients with menstrual disorder,1 case with conservative treatment(bromocriptine)recovered to normal,menstruation disappeared occurred in 2 cases,1 case with irregular menstruation.Patients with meningeal stimulation syndrome are 2 cases,the syndrome disappeared after operation;Disturbance of consciousness occured to the patients with acute pituitary apoplexy and ion disorders;2 patients died with transcranial approach operation.Conclusion:The incidence of pituitary adenoma apoplexy was 6.86% in this study,the incidence of men is higher than women.male female ratio is 1.76:1,All ages' groups may suffer the disease.Pituitary adenoma apoplexy is not caused by single factor,we should integrate all kinds of factors,and make a further research on the pathogenesis of pituitary adenoma apoplexy,in order to reduce the incidence of pituitary adenoma apoplexy.Large adenoma stroke occurred more easier than microadenoma,non-functioning pituitary adenoma higher risk of pituitary tumor apoplexy.MRI is superior to CT examination,but when bleeding at acute stage,CT examination is superior to MRI.patients with pituitary adenoma apoplexy patients can choose conservative treatment when clinical symptoms are mild,if the clinical symptoms of the patients were heavier or progressive,they should take surgical treatment,especially with transsphenoidal approach.