成人自发性肾上腺出血3例报告并文献复习  

Spontaneous adrenal hemorrhage in adults(3 cases)

作　　者：赵为广[1] 孙光[1] 刘晓强[1] 王一[1] 刘雨[1] 

机构地区：[1]天津医科大学第二医院泌尿外科,天津300211

出　　处：《中国现代医学杂志》2010年第24期3793-3795,共3页China Journal of Modern Medicine

摘　　要：目的探讨成人自发性肾上腺出血的临床特征及诊疗方法。方法回顾性分析该院经手术和病理证实的3例成人自发性肾上腺出血患者的临床资料,结合文献复习讨论成人自发性肾上腺出血的病因、诊断和治疗。男2例,女1例;年龄18~50岁;左侧2例,右侧1例。突发性上腹部疼痛或腰痛入院。肾上腺功能均正常。CT无增强改变。结果均行肾上腺及肿块切除术,术后病理报告为肾上腺出血伴坏死纤维化。术后随访3个月~5年,均无肾上腺皮质功能低下表现。结论成人自发性肾上腺出血术前易被误诊为肾上腺肿瘤,对于保守治疗无效、进行性出血、症状不断加重或伴有同侧肾上腺肿瘤的患者可行手术治疗。【Objective】To investigate the clinical features of spontaneous adult adrenal hemorrhage and the methods of diagnosis and treatment.【Methods】3 cases of spontaneous adult adrenal hemorrhage confirmed by surgery and pathology between Mar.2004 and Dec.2009 were retrospectively analyzed.The etiopathogenisis,diagnosis and treatment of spontaneous adult adrenal hemorrhage were discussed with review of the literature.Of the 3 cases,2 had left lesion and 1 had right lesion.2 cases manifested accidental upper abdominal pain and 1 case manifested lumbago in trouble side.The functions of adrenal gland were all normal.CT showed no contrast enhancement.【Results】3 cases underwent resection of adrenal gland and masses,the pathology of postoperation were adrenal hemorrhage accompanying necrosis and fibrosis.The functions of adrenal glad were all normal with follow-up of 0.25 to 5 years.【Conclusions】Spontaneous adult adrenal hemorrhage was easy to be misdiagnosed as adrenal tumor and operation was priorly considered.Ultrasound-B,CT and MRI were useful for establishing a timely diagnosis.The operation should be performed when conservative treatment was ineffective,hemorrhage and symptom were aggravating or accompanying adrenal tumor in trouble side.

关 键 词：肾上腺疾病 出血 成人 

分 类 号：R699.3[医药卫生—泌尿科学] R586.21[医药卫生—外科学]