垂体卒中与冠状动脉旁路移植术：我们是否应该改变策略？

Pituitary apoplexy and CABG: should we change our strategy?

作者信息

Levy Eli, Korach Amit, Merin Gideon, Feinsod Moshe, Glenville Brian

机构信息

Division of Cardiothoracic Surgery, Hadassah University Hospital, Jerusalem, Israel.

出版信息

Ann Thorac Surg. 2007 Oct;84(4):1388-90. doi: 10.1016/j.athoracsur.2007.05.017.

DOI:10.1016/j.athoracsur.2007.05.017

PMID:17889010

Abstract

Patients with pituitary adenoma that had coronary artery bypass grafting with cardiopulmonary bypass had pituitary apoplexy develop with neurologic deficits and even death. Four patients with pituitary adenoma underwent coronary artery bypass grafting operations (3 patients had coronary artery bypass grafting on bypass, 1 of them with known pituitary adenoma. All of them had pituitary apoplexy develop with neurologic deficits). One patient with known pituitary adenoma who had a coronary artery bypass grafting operation off pump was neurologically intact. Our recommendation is to consider operating on patients with pituitary adenoma who need coronary artery bypass grafting operation off pump, and to prevent pituitary apoplexy that cardiopulmonary bypass may cause.

摘要

患有垂体腺瘤且接受体外循环冠状动脉搭桥术的患者发生了垂体卒中，并出现神经功能缺损甚至死亡。4例垂体腺瘤患者接受了冠状动脉搭桥手术（3例在体外循环下进行冠状动脉搭桥，其中1例已知患有垂体腺瘤。他们均发生了伴有神经功能缺损的垂体卒中）。1例已知患有垂体腺瘤且在非体外循环下进行冠状动脉搭桥手术的患者神经功能完好。我们的建议是考虑对需要进行非体外循环冠状动脉搭桥手术的垂体腺瘤患者进行手术，并预防体外循环可能导致的垂体卒中。