不同手术方式治疗醛固酮腺瘤患者的有效性及安全性探讨  

The Efficacy and Safety of Different Surgical Methods in the Treatment of Patients with Aldosterone Adenoma

作　　者：陈宸[1] 蒲军[1] CHEN Chen;PU Jun(Department of Urology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院泌尿外科,重庆400016

出　　处：《医学信息》2019年第8期116-118,122,共4页Journal of Medical Information

摘　　要：目的通过对比腹膜后腹腔镜下肾上腺全切术与腹膜后腹腔镜下肾上腺肿瘤切除术治疗醛固酮腺瘤患者的相关指标,为临床应用后腹腔镜下肾上腺肿瘤切除术治疗醛固酮腺瘤患者提供依据。方法回顾性分析2014年1月～2018年9月重庆医科大学附属第一医院收治的103例醛固酮腺瘤患者的临床资料,32例行后腹腔镜下肾上腺全切术,71例行后腹腔镜下肾上腺肿瘤切除术。术后随访1～41个月,平均15.7个月。比较两组患者手术时间、术中术后并发症发生率,术后皮质醇不足发生率、引流管留置时间、术后住院时间,术后血压缓解率及复发率。结果肾上腺全切组手术时间为(117.00±47.00)min,术中术后并发症发生率为9.37%,术后住院时间为(5.20±3.10)d,均高于肾上腺肿瘤切除组的(78.00±32.00)min、0、(4.00±1.10)d,差异有统计学意义(P<0.05);两组患者术中出血量及引流管留置时间,术后皮质醇不足发生率比较,差异无统计学意义(P>0.05)。全切组和肿瘤切除组术后血压缓解率分别为90.63%和81.69%,组间比较差异无统计学意义(P>0.05),全切组复发率为0,低于肿瘤切除组的4.23%,但二者间差异无统计学意义(P>0.05)。结论鉴于后腹腔镜下肾上腺肿瘤切除术的良好的手术效果,技术上安全可靠,虽然有较小概率复发可能,仍是醛固酮腺瘤患者的一个良好选择。Objective To compare the relevant parameters of retroperitoneal laparoscopic adrenalectomy and retroperitoneal laparoscopic adrenalectomy for patients with aldosterone adenoma,and to provide a basis for clinical application of laparoscopic adrenalectomy for aldosterone adenoma.Methods Retrospective analysis of clinical data of 103 patients with aldosterone adenoma admitted to the First Affiliated Hospital of Chongqing Medical University from January 2014 to September 2018,32 patients underwent retroperitoneal laparoscopic adrenalectomy,and 71 patients underwent retroperitoneal laparoscopic adrenal gland Tumor resection.The patients were followed up for 1 to 41 months,with an average of 15.7 months.The operation time,intraoperative and postoperative complications,postoperative cortisol deficiency,drainage tube indwelling time,postoperative hospital stay,postoperative blood pressure remission rate and recurrence rate were compared between the two groups.Results The operation time of the adrenal gland was(117.00±47.00)min,the postoperative complication rate was 9.37%,and the postoperative hospital stay was(5.20±3.10)d,which was higher than that of the adrenal tumor resection group(78.00±32.00)min,0,(4.00±1.10)d,the difference was statistically significant(P<0.05);the intraoperative blood loss and drainage tube indwelling time,the incidence of postoperative cortisol deficiency,the difference was not statistically significant(P>0.05).The postoperative blood pressure remission rate was 90.63%and 81.69%in the total cut group and the tumor resection group,respectively.There was no significant difference between the two groups(P>0.05).The recurrence rate in total resection group was 0 lower than that in tumor resection group 4.23%,but there was no significant difference between the two groups(P>0.05).Conclusion In view of the good surgical results of retroperitoneal laparoscopic adrenalectomy,it is technically safe and reliable,and although it has a small probability of recurrence,it is still a good choice for patient

关 键 词：醛固酮腺瘤 后腹腔镜下肾上腺全切术 后腹腔镜下肾上腺肿瘤切除术 

分 类 号：R736.6[医药卫生—肿瘤] R699.3[医药卫生—临床医学]