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一些蝶鞍增大的患者,可无症状或只有头痛。蝶鞍增大可以是空泡而不包含肿瘤,或包含无症状或“无功能(burned out)”的垂体肿瘤,故正确的诊断和处理这些患者有一定困难。作者分析了连续100例因蝶鞍增大住院的患者,均因出现头痛、内分泌症状、昏厥、头晕、抽搐、高血压窦炎及鼻液溢作过颅骨摄片。22例主诉视力障碍或视野缺损和3例有肢端肥大症的被除外。余下75例为研究的对象,作了同位素脑扫描、脑电图、蝶鞍层面X线照相、脑脊液检查、切线屏幕(Jangentscreen)视野检查、内分泌试验、动脉造影和气脑造影。根据气脑造影、动脉造影和颅骨切开术作出最后诊断。结果:原发性鞍内肿瘤27例,空泡蝶鞍综合征25例,鞍外隆突13例,10例未作气脑造影未能确诊的患者则随诊3年,无内分泌、视力和神经征,蝶鞍大小、外形无改变,说明是良性过程。原发性鞍内肿瘤患者27例中,18例有垂体功能异常的症状。作催乳激
Some patients with enlarged sella may be asymptomatic or have only headaches. Stomach enlargement can be vacuous without tumors or pituitary tumors that are asymptomatic or “burned out”, so it is difficult to diagnose and treat these patients correctly. The authors analysed consecutive 100 patients who had been hospitalized because of enlarged sella, and all had headaches, endocrine symptoms, fainting, dizziness, convulsions, hypertensive sinusitis, and nasal fluid leakage. Twenty-two patients complained of visual impairment or visual field defects and three had acromegaly. The remaining 75 subjects were studied, including isotope brain scans, electroencephalograms, sella-level X-rays, cerebrospinal fluid examinations, tangent screens (Jangentscreen), perimetry, endocrinology, arteriography, and air brain imaging. The final diagnosis was based on anerography, arteriography, and craniotomies. RESULTS: There were 27 cases of primary intracranial tumors, 25 cases of vacuolar sella syndrome, and 13 cases of extracranial carinas. 10 cases without diagnosis were followed up for 3 years without endocrinology, visual acuity and Neural signs, size and appearance of the sella did not change, indicating a benign process. Of the 27 patients with primary intracranial tumors, 18 had symptoms of pituitary dysfunction. Actinic stimulation