CAJ | 학술논문

目的探讨皮质醇增多症患者术后激素替代方法。方法回顾分析75例皮质醇增多症术后激素替代方法和效果。结果围手术期给予超生理剂量糖皮质激素,逐渐减量,出院时每日口服强的松5～7.5mg。肾上腺皮质腺瘤患者激素替代时间为4～15个月,双侧肾上腺切除术者终生激素替代。8例肾上腺皮质腺瘤在激素减量过程中出现肾上腺皮质功能减退症状,其中2例血浆皮质醇在正常范围。结论皮质醇增多症患者术后在激素减量过程中即使血浆皮质醇水平在正常范围也可能有肾上腺皮质功能减退症状。
목적탐토피질순증다증환자술후격소체대방법。방법회고분석75례피질순증다증술후격소체대방법화효과。결과위수술기급여초생리제량당피질격소,축점감량,출원시매일구복강적송5～7.5mg。신상선피질선류환자격소체대시간위4～15개월,쌍측신상선절제술자종생격소체대。8례신상선피질선류재격소감량과정중출현신상선피질공능감퇴증상,기중2례혈장피질순재정상범위。결론피질순증다증환자술후재격소감량과정중즉사혈장피질순수평재정상범위야가능유신상선피질공능감퇴증상。
Objective To investigate the methods of steroid supplement following adrenalectomy in the patients with Cushing syndrome.Methods The methods and outcome of steroid supplement following adrenalectomy in 75 cases of Cushing syndrome were retrospectively reviewed.Results Supraphysiological doses of glucocorticoid was given during the perioperative period,and the dosage was reduced gradually.Prednisone with a dosage of 5 to 7.5 mg was given once a day on discharge.In the patients with adrenocortical adenoma,4 to 15 month of steroid supplement was required.The patients undergoing bilateral adrenalectomy required lifelong steroid supplementation.Steroid withdrawal syndrome occurred during steroid tapering in 8 patients with adrenocortical adenoma,2 of them had normal plasma cortisol level.Conclusion In the patients with Cushing syndrome,even those with normal plasma cortisol level might have steroid withdrawal syndrome episodes during steroid tapering.