CAJ | 학술논문

目的:探讨肾上腺性性征异常的诊断、鉴别诊断和治疗,特别是分泌性激素的肾上腺肿瘤的良恶性鉴别诊断和各种先天性肾上腺增生疾病的治疗原则.方法:报告1986年～1996年8例先天性肾上腺皮质增生和5例分泌性激素的肾上腺肿瘤的诊治经验.结果:先天性肾上腺皮质增生中有3例17-α羟化酶缺乏症,肿瘤患者包括2例女性男性化、3例男性女性化肾上腺肿瘤.分泌性激素肾上腺肿瘤均经手术切除.结论:分泌性激素的肾上腺皮质肿瘤的重量、直径(DHEA)、尿17酮和血性激素水平、CT表现和肿瘤浸润及转移可作为判断肿瘤良恶性的参考指标.对大体积肾上腺肿瘤首选改良肋缘下切口.先天性肾上腺皮质增生应根据疾病类型而选用不同皮质激素进行治疗,对于17-α羟化酶缺乏的病例.儿童期至青春期不宜应用性激素治疗.
목적:탐토신상선성성정이상적진단、감별진단화치료,특별시분비성격소적신상선종류적량악성감별진단화각충선천성신상선증생질병적치료원칙.방법:보고1986년～1996년8례선천성신상선피질증생화5례분비성격소적신상선종류적진치경험.결과:선천성신상선피질증생중유3례17-α간화매결핍증,종류환자포괄2례녀성남성화、3례남성녀성화신상선종류.분비성격소신상선종류균경수술절제.결론:분비성격소적신상선피질종류적중량、직경(DHEA)、뇨17동화혈성격소수평、CT표현화종류침윤급전이가작위판단종류량악성적삼고지표.대대체적신상선종류수선개량륵연하절구.선천성신상선피질증생응근거질병류형이선용불동피질격소진행치료,대우17-α간화매결핍적병례.인동기지청춘기불의응용성격소치료.
Objective: To inquire into diagnosis, and treatment of virilizing and feminizing adrenal syndrome, differential diagnosis between benign and malignant sex hormone producing adrenal neoplasma and, treatment principles of congenital adrenal hyperplasia ( CAH ) . Methods: Eight cases of CAH and 5 cases of sex hormone producing adrenal neoplasma were admitted to hospital during 1986-1996. The former included 3 rare cases of 17 a hydroxylase deficiency. The latter included 3 cases of feminizing adrenal tumor and 2 cases of virilizing adrenal tumor. Results: Weight, size and CT of the tumor, DHEA, 17-ks, sex hormone levels, infiltration, and metastasis were closely related to the degree of differentiation of the tumors. Conclusion: Virilizing and feminizing adrenal neoplasm were removed surgically by different incisions. Modified subcostal incision was recommended as the best choice for huge adrenal mass. Corticoadrenal hormone treatment fo CAH should be individualized according to the different types of the disease. Sex hormones were not suitable for children suffering from 17 hydroxylase deficiency before puberty.