摘要
目的提高肾上腺嗜铬细胞瘤的诊断水平,完善其围手术期处理。方法对74例经手术治疗的肾上腺嗜铬细胞瘤患者的临床资料进行回顾性分析,有典型高儿茶酚胺症状者68例,24 h尿VMA定性检查66例增高,阳性率达89.2%;B超,CT,MRI定位检查阳性率分别为86.4%,97.1%和100%。结果所有患者手术成功切除肿瘤共75个,经病理检查证实良性72例(97.3%)、恶性3例(2.7%)。该组无手术死亡病例。结论肾上腺嗜铬细胞瘤主要根据临床表现、实验室定性检查及影像学定位检查来明确诊断。术前血压控制、充分扩容、改善心功能、纠正心衰,术中避免不必要的探查,术中、术后应用升压药物等围手术期处理是确保手术成功的重要因素。
Obsjective: To improve the diagnosis of pheochromocytoma and evaluate the treatment strategy around the operation. Methods: 74 Cases of pheochromocytoma diagnosed and treated between 1990 and 2002 were reviewed and studied: there were 68 cases with high blood catecholamine. Urinary Vanillyl-mandelic acid (VMA) was a better marker with a positive sensitivity rate of 89.2%. The accurate localization rate of the tumors was 86.4% for B-ultrasohography, 97.1% for CT and 100% for MRI. Results: 75 tumors was successfully cut in the operation of all cases. The diagnosis was confirmed by pathologic studies. 72 cases (97.3%) were benign and other 3 cases (2.7%) were malignant. Conclusions: The procedures of the qualitative and locative diagnosis of adrenal gland pheochromocytoma include clinical manifestations, urinary VMA assessment and imaging investigation. Adequate preoperative preparation is important included control of blood pressure and arrhythmia, expansion of the blood volume. Fluctuation of blood pressure have to be monitored during and after surgery and to be treated carefully and promptly.
出处
《中国现代医学杂志》
CAS
CSCD
2004年第23期86-88,91,共4页
China Journal of Modern Medicine
关键词
肾上腺肿瘤
嗜铬细胞瘤
诊断
治疗
adrenal gland neoplasms
pheochromocytoma
diagnosis
treatment
