原发性醛固酮增多症（PHA）84例的诊断及手术治疗经验

发布时间：2018-07-04 21:20

本文选题：醛固酮增多症 + 典型　；参考：《重庆医科大学》2015年硕士论文

【摘要】：目的回顾总结原发性醛固酮增多症(primary hyperaldosteronism, PHA)的诊断及治疗经验。方法回顾分析2009年1月至2013年12月在我院诊断为PHA患者84例,根据临床表现、血钾、24小时尿钾、血气分析、立位醛固酮与肾素比值(aldosterone-to-renin ratio, ARR)、肾上腺静脉取血(adrenal vein sample, AVS)、卡托普利抑制试验、CT定位检查及术后病理确诊为PHA,采用后腹腔镜肾上腺肿瘤切除术治疗,将患者分为典型临床表现组和不典型临床表现组；对比两组患者肿瘤大小、术前ASA(美国麻醉师协会)分级、手术时间、术中出血量、术前准备时间、术后住院时间。结果典型组与不典型组肿瘤最大径、手术时间、术后住院时间、术中出血量无显著差异(P0.05)；典型组和不典型组术前准备时间、术前ASA分级有显著差异(P0.001)。结论典型和不典型PHA诊断及治疗无差别；典型组较不典型组手术风险高,需要较长的术前准备时间；AVS适用于早期PHA确诊或定位困难者。
[Abstract]:Objective to review the experience in diagnosis and treatment of primary aldosteronism (primary hyperaldosteronism,). Methods 84 cases of PHA diagnosed in our hospital from January 2009 to December 2013 were retrospectively analyzed. According to the clinical manifestations, 24 hours urine potassium and blood gas were analyzed. The ratio of aldosterone to renin (ar), the adrenal vein blood (adrenal vein sample, the CT localization of captopril inhibition test and the postoperative pathological diagnosis were confirmed by retroperitoneal laparoscopic adrenalectomy (Laparoscopic resection of adrenal neoplasms). The patients were divided into typical clinical manifestations group and atypical clinical manifestation group. The tumor size, preoperative ASA classification, operative time, intraoperative bleeding volume, preoperative preparation time and postoperative hospitalization time were compared between the two groups. Results there was no significant difference between the typical group and the atypical group in tumor maximum diameter, operation time, postoperative hospitalization time and intraoperative bleeding volume (P0.05), but there was significant difference between the typical group and the atypical group in preoperative preparation time and preoperative ASA grade (P0.001). Conclusion there is no difference in diagnosis and treatment between typical PHA and atypical PHA, and the risk of operation in the typical group is higher than that in the atypical group.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R586.24

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