摘要
目的 提高肾上腺腺瘤型原发性醛固酮增多症 (简称原醛症 )的诊治水平。 方法 回顾性分析 1978～ 2 0 0 1年 2月收治的 149例经手术和病理证实的肾上腺腺瘤型原醛症患者诊断治疗及预后的临床资料。 结果 腹膜后充气造影、B超和CT在肾上腺腺瘤型原醛症诊断中的特异性分别为 :39 0 %、6 7 0 %和 95 3%,腹膜后充气造影与B超和CT诊断特异性比较 ,差异有显著意义 (χ2 =2 3 89,P <0 .0 1) ,B超与CT诊断特异性比较差异有显著意义 (χ2 =32 10 ,P <0 0 1)。术后 1个月所有患者血钾恢复正常 ,术后 2个月内 110例 (73 8%)患者血压恢复正常。 结论 B超和CT检查是肾上腺腺瘤型原醛症定位诊断的主要方法 ,手术是主要的治疗手段 ,腹腔镜肾上腺切除术是一种很有前途的治疗方法。影响疗效的因素 ,主要与患者年龄大、病史长、全身血管硬化有关。
Objective To evaluate the diagnosis and treatment of aldosterone-producing adreral cortical neoplasms. Methods From 1978 to February 2001,149 patients with aldosterone-producing adrenal cortical neoplasms were diagnosed and treated. Of these patients, 148 had adrenal adenoma and 1 had adrenal cortical carcinoma. The diagnosis was all confirmed by surgery and pathological studies. Results The diagnostic specificity of retroperitoneal pneumography, B-ultrasonography and CT scan are 39%, 67% and 95.3% respectively. It was found that there were singnificant differences of diagnostic specificity between retroperitoneal pneumography and B-ultrasonography, CT scan (χ 2=23.89, P<0.05) and there were singnificant differences between B-ultrasonography and CT scan (χ 2=32.10, P<0.05). In all the patients, serum potassium level elevated to normal range within 1 month postoperatively. In 110 cases out of 149, the blood pressure dropped to normal range within two months after surgery. Conclusions Appropriate treatment depends on correct qualitative diagnosis and localization of the causative lesion. B-ultrasonography and CT scan play an important role in diagnosis. Surgery is the major treatment, including laparoscopic adrenalectomy. Factors affecting the therapeutic outcome are agings systemic vascular sclerosis and long duration of the disease.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2001年第12期937-939,共3页
Chinese Journal of Surgery
