孙立安 张永康 王国民 郭剑明 戎瑞明 200032 上海医科大学附属中山医院泌尿外科 中华泌尿外科杂志 1999 0 20 11


    关键词：嗜铬细胞瘤；诊断；治疗 期刊 zhmnwkzz 0 论著 fur --> /literature/clinic/diagnose/diagnose02.asp?keyword=嗜铬细胞瘤；诊断；治疗


    

【摘要】 目的 探讨嗜铬细胞瘤的诊断治疗。 方法 报告1967～1997年收治的 85 例嗜铬细胞瘤。临床表现为高血压者78例(92%)，73例尿VMA检查，其中68例高于正常，阳性率93%。B超、CT和MRI定位诊断的阳性率分别为90%、96%和100%。 结果 全部病例均经手术和病理证实，其中良性77例(91%)，恶性8例(9%)；肿瘤位于肾上腺 71例(84%)，异位嗜铬细胞瘤14例 (16%)。 结论 强调充分的术前准备，手术切除肿瘤是根本的治疗方法。

Diagnosis and treatment of pheochromocytoma (report of 85 cases)

SUN Lian,ZHANG Yongkang,WANG Guomin,et al

    Department of Urology,Zhongshan Hospital,Shanghai Medical University,Shanghai 200032

【 Abstract】 Objective To evaluate the diagnostic and treatment procedures for pheochromocytoma. Methods 85 cases of pheochromocytoma diagnosed and treated between Dec.1967 and Dec.1997 were reviewed and studied.92% of the cases manifested hypertension.Urinary VMA,serum and urinary catecholamines were studied showing good sensitivity.Urinary VMA has been the best marker with a positive sensitivity of 93.0%.The accuracy rates of localization of B-ultrasonography,computerized tomography and magnetic resonance imaging were 90%,96% and 100% respectively.Preoperative preparation with α -adrenergic blocker for hypertension and β -adrenergic blocker against arrhythmias were essential.The diagnosis of pheochromocytoma was confirmed on surgery and pathologic studies in all. Results In 77 cases (91%),the pheochromocytoma was benign and in the other 8 the tumor was malignant (9%).The tumor was located in the adrenal gland in 71 (84%),being on the left side in 27 (32%),on the right in 42 (49%) and bilateral in 2 (2%).In 14 cases (16%),the tumors were extraadrenal.Recurrance of the pheochromocytoma occurred in 4 with increased tendency of malignancy. Conclusions Surgical management was the only means for cure and preoperative preparation was extremely important.

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