中华内分泌外科杂志
中華內分泌外科雜誌
중화내분비외과잡지
CHINESE JOURNAL OF ENDOCRINE SURGERY
2010年
1期
46-47,69
,共3页
肾上腺%嗜铬细胞瘤
腎上腺%嗜鉻細胞瘤
신상선%기락세포류
Adrenal glands%Pheochromocytoma
目的 提高肾上腺隐匿性嗜铬细胞瘤诊断意识和治疗水平.方法 回顾性分析15例肾上腺隐匿性嗜铬细胞瘤临床资料.既往无高血压病史.术前均行B超、CT及实验室检查,拟诊无功能肾上腺皮质腺瘤4例、肾上腺隐匿性嗜铬细胞瘤11例.结果 15例均手术切除肿瘤,其中开放手术9例,后腹腔镜手术6例.术中出现血压波动10例,硝普钠控制高血压,去甲肾上腺素处理低血压;4例拟诊肾上腺皮质腺瘤术中均出现血压波动,余11例血压波动6例,其中服用酚苄明患者无明显血压波动.术后病理均为嗜铬细胞瘤.14例术后随访3个月～8年,血压正常,肿瘤无复发.结论 综合分析实验室检查结果 及影像学表现,可提高诊断意识;术前常规应用α受体阻滞剂及扩容治疗,可提高手术安全性,减少并发症;后腹腔镜手术效果良好.
目的 提高腎上腺隱匿性嗜鉻細胞瘤診斷意識和治療水平.方法 迴顧性分析15例腎上腺隱匿性嗜鉻細胞瘤臨床資料.既往無高血壓病史.術前均行B超、CT及實驗室檢查,擬診無功能腎上腺皮質腺瘤4例、腎上腺隱匿性嗜鉻細胞瘤11例.結果 15例均手術切除腫瘤,其中開放手術9例,後腹腔鏡手術6例.術中齣現血壓波動10例,硝普鈉控製高血壓,去甲腎上腺素處理低血壓;4例擬診腎上腺皮質腺瘤術中均齣現血壓波動,餘11例血壓波動6例,其中服用酚芐明患者無明顯血壓波動.術後病理均為嗜鉻細胞瘤.14例術後隨訪3箇月～8年,血壓正常,腫瘤無複髮.結論 綜閤分析實驗室檢查結果 及影像學錶現,可提高診斷意識;術前常規應用α受體阻滯劑及擴容治療,可提高手術安全性,減少併髮癥;後腹腔鏡手術效果良好.
목적 제고신상선은닉성기락세포류진단의식화치료수평.방법 회고성분석15례신상선은닉성기락세포류림상자료.기왕무고혈압병사.술전균행B초、CT급실험실검사,의진무공능신상선피질선류4례、신상선은닉성기락세포류11례.결과 15례균수술절제종류,기중개방수술9례,후복강경수술6례.술중출현혈압파동10례,초보납공제고혈압,거갑신상선소처리저혈압;4례의진신상선피질선류술중균출현혈압파동,여11례혈압파동6례,기중복용분변명환자무명현혈압파동.술후병리균위기락세포류.14례술후수방3개월～8년,혈압정상,종류무복발.결론 종합분석실험실검사결과 급영상학표현,가제고진단의식;술전상규응용α수체조체제급확용치료,가제고수술안전성,감소병발증;후복강경수술효과량호.
Objective To improve the diagnosis and treatment of occult pheochromocytoma of adrenal glands. Methods The clinical records of 15 cases of occult pheochromocytoma of adrenal glands were analyzed restrospectively. Among the cases, 6 cases were male and 9 cases were female. The average age was 41.5 years. They had no high blood pressure history. They were given B ultrosound, CT and labarotory examination before operation, 4 cases were diagnosed as nonfunctional adrenocortical tumor, 11 cases were occult pheochromocytoma of adrenal glands. Results 15 cases underwent operation, 9 cases open surgery and 6 cases retroperitoneal laparoscopic surgery. Fluctuation of blood pressure occurred during the operation in 10 cases. High blood pressure was controlled by nitroprusside, and low blood pressure by notepinephrin. Fluctuation of blood pressure occurred in 4 cases of suspicious adrenocortical tumor during the operation, fluctuation of blood pressure occurred during the operation in 6 of other 11cases. Fluctuation of blood pressure did not occure in patients treated with phenoxybenzamine. The postoperative pathological diagnosis of these patients was pheochromcytoma without exception 14 cases were followed for 3 months to 8 years, the blood pressure of these 14 cases were nomal and the tumor had no metastasis. Conclusions Analyzing the results of labarotory examination and imaging examination could improve the accuracy of diagnosis and using receptor blocking agent and blood volume expander could raisee the safety of operation and decrease the complications. Retroperitoneal laparoscopic surgery is effective.
