21例肾上腺危象的临床诊疗分析  

Clinical analysis of 21 cases adrenal crisis diagnosis and treatment

作　　者：赵林岩[1] 李芳[2] 邵晓艳 朱丹丹[1] 于健[1] Zhao Linyan;Li Fang;Shao Xiaoyan;Zhu Dandan;Yu Jian(Department of Critical Care Medicine The Second Hospital of Dalian Medical University,Liaoning,Dalian,China;Department of neurology Dalian Municipal Central Hos pital Affiliated Of Dalian Medical University,Liaoning,Dalian,China)

机构地区：[1]大连医科大学附属第二医院重症医学科 [2]大连医科大学附属中心医院神经内科

出　　处：《实用休克杂志（中英文）》2020年第4期213-214,218,共3页Journal of Practical Shock

基　　金：2020年度辽宁省自然科学基金计划项目(项目编号:2020-MS-263)。

摘　　要：目的探讨肾上腺危象的临床特点、诊断、治疗方法及疗效。方法回顾性分析2006年12月至2020年6月大连医科大学附属第二医院诊治的21例肾上腺危象患者的临床资料。其中7例患者曾行肾上腺手术,2例患者曾行垂体瘤手术。5例患者自行停用糖皮质激素。21例患者中5例患者肾上腺危象发作次数≥2次,11例患者首发症状为消化道症状。21例患者均经实验室检查确诊,并给予综合治疗。结果 21例患者均予积极的补液、纠正电解质紊乱、氢化可的松补充糖皮质激素治疗后好转出院。结论肾上腺危象多为肾上腺功能减退患者因自行停用糖皮质激素、感染等原因引起,应早期识别、早期诊断及早期综合治疗,氢化可的松的应用至关重要。同时应早期预防和患者教育。Objective To study the clinical features,diagnosis,treatment and curative effect of adrenal crisis.Methods We retrospectively analyzed the etiology,clinical manifestations,laboratory examination,imaging features and diagnosis of 21 patients with adrenal crisis treated in the Second Affiliated Hospital of Dalian Medical University from December 2006 to Six 2020.Among them,7 patients had adrenalectomy,2 patients had pituitary tumor operation and5 patients stopped using glucocorticoids by themselves.Among the 21 patients,5 had adrenal crisis attack≥2 times,and the first symptom of 11 patients was gastrointestinal symptoms.21 patients were confirmed by laboratory examination,and comprehensive treatment.Results 21 patients were treated with active rehydration,electrolyte disorder correction,hydrocortisone and glucocorticoid.After treatment,21 patient cured.Conclusions Adrenal crisis is mainly caused by the patients with adrenal hypofunction who stop using glucocorticoids and infection.It is necessary to recognize,diagnose and treat it in early stage.The application of hydrocortisone is very important.At the same time,early prevention and patient education should be carried out.

关 键 词：肾上腺危象 临床特点 诊断 疗效 

分 类 号：R586[医药卫生—内分泌]