国际泌尿系统杂志
國際泌尿繫統雜誌
국제비뇨계통잡지
INTERNATIONAL JOURNAL OF UROLOGY AND NEPHROLOGY
2012年
3期
326-329
,共4页
醛固酮增多症%肾上腺疾病
醛固酮增多癥%腎上腺疾病
철고동증다증%신상선질병
Ilyperaldosteronism%Adrenal Gland Diseases
目的 探讨单侧肾上腺结节性原发性醛固酮增多症的几种诊断方法的阳性率及治疗效果.方法 回顾性分析2006年1月至2011年1月经手术及病理确诊的单侧肾上腺皮质结节增生性原发性醛固酮增多症患者27例,男13例,女14例.以头痛头晕就诊22例,体检发现肾上腺占位就诊5例.27例患者均有高血压病史,患病时间中位时间2年(1个月～24年).所有患者均行肾上腺B超及薄层CT扫描,其中行肾上腺静脉采血(AVS)检查16例.结果 :B超、CT及AVS采血阳性率分别为66.7％、92.6％、93.8％.2例行开放,25例行经后腹腔镜患侧肾上腺切除术,术后随访20例,18例术后6个月内血压恢复正常；2例6个月后血压控制不理想,1例需2种以上降压药物联合降压.结论 单侧肾上腺皮质结节增生性原发性醛固酮增多症是一种可以通过手术治愈的疾病,需要反复检测血浆醛固酮及肾素等,CT及肾上腺静脉采血是其术前分型定侧诊断的重要手段.
目的 探討單側腎上腺結節性原髮性醛固酮增多癥的幾種診斷方法的暘性率及治療效果.方法 迴顧性分析2006年1月至2011年1月經手術及病理確診的單側腎上腺皮質結節增生性原髮性醛固酮增多癥患者27例,男13例,女14例.以頭痛頭暈就診22例,體檢髮現腎上腺佔位就診5例.27例患者均有高血壓病史,患病時間中位時間2年(1箇月～24年).所有患者均行腎上腺B超及薄層CT掃描,其中行腎上腺靜脈採血(AVS)檢查16例.結果 :B超、CT及AVS採血暘性率分彆為66.7％、92.6％、93.8％.2例行開放,25例行經後腹腔鏡患側腎上腺切除術,術後隨訪20例,18例術後6箇月內血壓恢複正常；2例6箇月後血壓控製不理想,1例需2種以上降壓藥物聯閤降壓.結論 單側腎上腺皮質結節增生性原髮性醛固酮增多癥是一種可以通過手術治愈的疾病,需要反複檢測血漿醛固酮及腎素等,CT及腎上腺靜脈採血是其術前分型定側診斷的重要手段.
목적 탐토단측신상선결절성원발성철고동증다증적궤충진단방법적양성솔급치료효과.방법 회고성분석2006년1월지2011년1월경수술급병리학진적단측신상선피질결절증생성원발성철고동증다증환자27례,남13례,녀14례.이두통두훈취진22례,체검발현신상선점위취진5례.27례환자균유고혈압병사,환병시간중위시간2년(1개월～24년).소유환자균행신상선B초급박층CT소묘,기중행신상선정맥채혈(AVS)검사16례.결과 :B초、CT급AVS채혈양성솔분별위66.7％、92.6％、93.8％.2례행개방,25례행경후복강경환측신상선절제술,술후수방20례,18례술후6개월내혈압회복정상；2례6개월후혈압공제불이상,1례수2충이상강압약물연합강압.결론 단측신상선피질결절증생성원발성철고동증다증시일충가이통과수술치유적질병,수요반복검측혈장철고동급신소등,CT급신상선정맥채혈시기술전분형정측진단적중요수단.
Objectives To investigate the diagnosis and result of unilateral nodular adrenal hyperplasia in primary aldosteronism(UNAH).Methods From January 2006 to January 2011,we retrospective study 27 cases of UNAH by pathological results.There were 13 males and 14 females with a clinical symptoms of headache and dizziness in 22 cases,a physical examination of adrenal masses in 5 cases.All patients presented arterial hypertension for a mean time of 24 months ( 1 months to 24 years) and underwent adrenal ultrasound and MSCT,16 cases underwent adrenal venous sampling(AVS).Results The accuracy rate of ultrasound,computed tomography (CT)and AVS rate were 66.7％,92.6％ and 93.8％ respectively.Laparoscopic ipsilateral adrenalectomy was performed in 25 cases while open surgery in 2 cases.20 cases were follow up after UNAH operation in 6 months,the blood pressure of 18 cases were retumed to normal,2 cases were controlled unsatisfactory and one case need taking two antihypertensive drugs.Conclusions UNAH can be cured by adrenal surgery,requiring repeated testing plasma aldosterone and rennin.CT and AVS are the most important technology and methods in diagnosis of UNAH pre - operation.
