摘要
目的探讨席汉综合征合并垂体危象的临床特征和诊治过程,复习相关文献及最新进展。方法收集内蒙古医科大学附属医院2010年9月—2015年9月间收治的2例席汉综合征合并垂体危象患者资料,对其临床病例资料进行回顾性分析,并对席汉综合征致垂体危象进行相关文献复习。结果 2例患者均为产后大出血致席汉综合征,因意识欠佳收入院,入院查血钠低,分别为102.8 mmol/L、105.1 mmol/L,皮质醇降低,ACTH均<1 pg/mL,甲功呈垂体甲减状态。诊断席汉综合征并发垂体危象,予以氢化可的松100~400 mg/d静脉滴注,后改为口服泼尼松逐渐减量,同时加用优甲乐25~50μg口服,患者病情逐渐好转,意识恢复,出院后继续口服药物治疗。结论席汉综合征常有明确的产后大出血史,未予治疗的情况下有感染等诱因易发生垂体危象。所以,仔细询问病史并提高诊疗水平很关键。
Objective To investigate the clinical features and diagnosis and treatment course of Sheehan＇s syndrome and its crisis,and review for latest developments. Methods Collecting the clinical date of 2 cases Sheehan ＇s syndrome and its crisis admitted in the Affiliated Hospital of Inner Mongolia Medical University from September 2010 to September 2015,and retrospective analysis for its clinical dates,review the literrature for Sheehan＇s syndrome and its crisis. Results Nearly all these cases occurred after severe postpartum hemo rrhage, and have Poor consciousness to be admitted to hospital. Examination show there are low blood sodium（102.8 mmol/L、105.1 mmol/L）、plasma cortisol、adrenocorticotropic hormone（both 〈1 pg/mL） and pituitary hypothyroidism.Giving hydrocortisone（100 ～400 mg/d） treatment for Sheehan＇s syndrome and its crisis.They can take orally prednisone after following,also need L-thyroxine supplement 25～50 μg. After treatment of this, the patient is on the mend. Conclusion Nearly all these cases occurred after severe postpartum hemorrhage and the infection was the main precipitating cause. It is concluded that if a doctor meet a woman having delivery history,he should think of the disease so as to getting the early diagnosis and treatment.
出处
《世界复合医学》
2017年第1期55-57,共3页
World Journal of Complex Medicine
基金
国家自然科学基金项目(81660358)
内蒙古自治区自然科学基金项目(2016MS(LH)0803)
