对1例双侧肾上腺腺瘤导致的原发性醛固酮增多症二次手术的思考  

Thoughts on a case of re-operation for primary aldosteronism caused by bilateral adrenal adenomas

作　　者：赵菊平[1] 戴军[1] 林文浩 方晨[1] 徐丹枫[1] ZHAO Juping;DAI Jun;LIN Wenhao;FANG Chen;XU Danfeng(Department of Urology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院泌尿外科,上海200025

出　　处：《临床泌尿外科杂志》2023年第9期677-680,共4页Journal of Clinical Urology

摘　　要：原发性醛固酮增多症(primary aldosteronism,PA)是一种由于肾上腺皮质分泌过多醛固酮而导致的临床综合征,常见病因包括单侧肾上腺腺瘤、双侧肾上腺增生、单侧肾上腺增生。双侧肾上腺腺瘤比较少见,诊治过程需要依赖肾上腺静脉采血(adrenal venous sampling,AVS)辅助诊断优势侧。本文报道1例双侧肾上腺腺瘤导致的PA诊治过程,首次手术切除优势侧,术后血压血钾未改善,1年后再次行对侧肾上腺肿瘤切除,最终达到临床效果。该病例提示临床医生需进一步提高对于特殊类型PA的诊治水平。Primary aldosteronism(PA)is a clinical syndrome caused by excessive secretion of aldosterone by the adrenal cortex.The common causes include unilateral adrenal adenoma,bilateral adrenal hyperplasia and uni-lateral adrenal hyperplasia.Adrenal venous sampling is key for reliable subtype identification,especially for the bilateral adrenal adenomas with low incidence.This study reports the diagnosis and treatment of a case of bilateral adrenal adenomas caused by PA.The dominant side of adrenal gland was removed in the first operation,but the blood pressure and blood potassium did not improve postoperatively.One year later,the contralateral adrenal tumor was removed,and the clinical effect was finally achieved.This case indicates that clinicians should further increase the level of diagnosis and treatment of special types of PA.

关 键 词：肾上腺腺瘤 原发性醛固酮增多症 手术 

分 类 号：R636.6[医药卫生—外科学]