中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2014年
7期
520-523
,共4页
李新%董明%周建平%宋禾
李新%董明%週建平%宋禾
리신%동명%주건평%송화
嗜铬细胞瘤%诊断%外科手术
嗜鉻細胞瘤%診斷%外科手術
기락세포류%진단%외과수술
Pheochromocytoma%Diagnosis%Surgical procedures,operative
目的 总结腹部异位嗜铬细胞瘤的临床特点及诊治经验.方法 回顾性分析中国医科大学附属第一医院2005年1月至2012年12月收治的33例腹部异位嗜铬细胞瘤的临床资料.对其临床表现、诊治及预后进行分析.结果 异位嗜铬细胞瘤占同期收治嗜铬细胞瘤的16.2％(33/204).其中男13例,女20例,年龄(45±15)岁.以腹部不适等临床表现为主诉入院的14例(42.4％);有头晕、视物模糊等症状的8例(24.2％);1例膀胱嗜铬细胞肿瘤患者表现为排尿时心慌.10例(30.3％)没有明显的临床表现.33例患者均行CT检查,8例患者凭影像学表现做出诊断.1例无法切除仅作病理诊断,其余均行肿瘤切除术,1例联合左肾切除,1例联合胰尾脾切除.本组无围手术期死亡病例,预后良好.结论 异位嗜铬细胞瘤缺乏典型临床表现和特异性实验室检查手段,应重视其影像学表现,切除手术后预后良好.
目的 總結腹部異位嗜鉻細胞瘤的臨床特點及診治經驗.方法 迴顧性分析中國醫科大學附屬第一醫院2005年1月至2012年12月收治的33例腹部異位嗜鉻細胞瘤的臨床資料.對其臨床錶現、診治及預後進行分析.結果 異位嗜鉻細胞瘤佔同期收治嗜鉻細胞瘤的16.2％(33/204).其中男13例,女20例,年齡(45±15)歲.以腹部不適等臨床錶現為主訴入院的14例(42.4％);有頭暈、視物模糊等癥狀的8例(24.2％);1例膀胱嗜鉻細胞腫瘤患者錶現為排尿時心慌.10例(30.3％)沒有明顯的臨床錶現.33例患者均行CT檢查,8例患者憑影像學錶現做齣診斷.1例無法切除僅作病理診斷,其餘均行腫瘤切除術,1例聯閤左腎切除,1例聯閤胰尾脾切除.本組無圍手術期死亡病例,預後良好.結論 異位嗜鉻細胞瘤缺乏典型臨床錶現和特異性實驗室檢查手段,應重視其影像學錶現,切除手術後預後良好.
목적 총결복부이위기락세포류적림상특점급진치경험.방법 회고성분석중국의과대학부속제일의원2005년1월지2012년12월수치적33례복부이위기락세포류적림상자료.대기림상표현、진치급예후진행분석.결과 이위기락세포류점동기수치기락세포류적16.2％(33/204).기중남13례,녀20례,년령(45±15)세.이복부불괄등림상표현위주소입원적14례(42.4％);유두훈、시물모호등증상적8례(24.2％);1례방광기락세포종류환자표현위배뇨시심황.10례(30.3％)몰유명현적림상표현.33례환자균행CT검사,8례환자빙영상학표현주출진단.1례무법절제부작병리진단,기여균행종류절제술,1례연합좌신절제,1례연합이미비절제.본조무위수술기사망병례,예후량호.결론 이위기락세포류결핍전형림상표현화특이성실험실검사수단,응중시기영상학표현,절제수술후예후량호.
Objective To study the diagnosis and management of extra-adrenal pheochromocytoma.Methods A retrospective clinical study was done on 33 patients of extra-adrenal pheochromocytoma treated at our department.Results Extra-adrenal pheochromocytoma accounted for 16.2％ (33/204) of all pheochromocytoma patients admitted between Jan 2005 and Dec 2012.There were 13 males and 20 females.The mean age at diagnosis was 45 years,with a range from 17 to 81 years.14 patients were hospitalized for abdominal discomfort,8 patients suffered from typical hypertension symptoms including headache and dizziness and blurred vision,one of bladder pheochromocytoma was found paroxysmal hypertension and 10 patients had no obvious clinical symptoms.All the patients underwent CT scan,and 8 extra-adrenal pheochromocytoma were discovered.11 patients were given circulation expansion therapy.Most of the tumors were located at bladder(3 case),renal hilus (7 case) and para-aorta(23 case).There were two patients with multiple tumors.In 26 cases,blood pressure fluctuated when touching tumor during operation.All the patients were treated with surgical operation.Except for 1 biopsy,32 patients underwent total resection of tumor including a case combined resection with left kidney and a case with the spleen.There were no perioperative mortality.Postoperative follow up showed very good prognosis,with no death.Conclusions Compared with imaging examination,clinical manifestations and laboratory tests were less evaluable for the diagnosis of extra-adrenal pheochromocytoma.Proper preoperative preparation and precise operation is essential for the prognosis.
