肾上腺结节样增生性高血压的诊断与治疗(附31例报告)  

Diagnosis and treatement of adrenal nodular hyperplastic hypertension:31 cases report

作　　者：曲华伟[1] 郑峥[1] 蒋绍博[1] 王翰博[1] 熊晖[1] 金讯波[1] 

机构地区：[1]山东省立医院,山东济南250021

出　　处：《山东医药》2007年第21期5-6,共2页Shandong Medical Journal

摘　　要：目的探讨肾上腺结节样增生性高血压的诊断与治疗方法。方法回顾性分析31例肾上腺结节样增生性高血压患者的发病年龄、术前术后血压变化情况、影像学检查结果与术后病理的对应情况、术前术后实验室检查结果的变化情况。结果本组病例平均年龄38.8岁。CT检查阳性率达92.8%;术后血钾、24 h尿钾、血醛固酮均恢复正常,10例术前血皮质醇增高者8例降至正常,2例未完全恢复正常。术后1、3、6、12月的收缩压与舒张压与术前相比均明显下降。结论薄层CT扫描是诊断肾上腺结节样增生性高血压病的主要方法,实验室检查可作为辅助。腹腔镜患侧肾上腺全部切除术是肾上腺结节样增生性高血压病的有效治疗手段。[ Objective ] To investigate the diagnosis and treatment of adrenal nodular hyperplastic hypertension. [ Methods] The clinical data of 31 cases of adrenal nodular hyperplastic hypertension from 2002 to 2006 were retrospectively analyzed. Patients age, blood pressures ,laboratery examination and other clinical symptoms were analysed before operation and after operation. Result of B ultrasound , CT and MRI were compared with the pathology diagnosis. [ Results ] The average age was 38.8. The positive rate of CT examination was 92. 8% . All cases＇s postoperative figures of serum K ^＋ , urine potassium at 24 h and serum aldosterone became normal. Ameng 10 cases patients with serum cortisol increasing before operation,8 cases became nermal and 2 cases＇s serum cortisol were still above normalnm systolic blood presure and iustolic blood pressures at 1,3,6,12 months after operation was decreased compared with those before preoperative. [ Conclusions] Multi -slice spiral CT is the chief method for adrenal nodular hyperplastic hypertension diagnosis. The laboratory examination can be used as adjurandt method. A drenalectomy under laparoscopics is effective method for adrenal nodular hyperplastic hypertension.

关 键 词：肾上腺 结节 增生 高血压 腹腔镜 

分 类 号：R699.3[医药卫生—泌尿科学]