肾上腺偶发瘤切除术后高血压改善情况的相关因素分析

发布时间：2018-01-28 14:12

本文关键词： 肾上腺偶发瘤高血压疗效　出处：《大连医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的研究肾上腺偶发瘤切除术后高血压改善情况,分析相关影响因素。方法收集整理肾上腺偶发瘤伴高血压临床资料144例,根据术后血压变化分为有效组和无效组,比较两组临床资料差异并进行单因素及多因素分析。结果比较术前、术后血压变化情况,术后高血压有效改善为97例(67.36%),其中正常31例(21.53%),好转66例(45.83%);无效47例(32.64%)。术前依据血压情况分为1级、2级、3级三组,术后高血压改善率分别为72.13%、66.03%、60%。单因素分析发现肿瘤位置及术前血浆醛固酮浓度对术后血压变化有影响(P0.05),而性别、年龄、肿瘤大小、术前血压、高血压病程、肾上腺偶发瘤病程、是否合并糖尿病、术前血钾、术前血浆皮质醇浓度、术前促肾上腺皮质激素(ACTH)、术前尿香草基扁桃酸(尿VMA)、术前血管紧张素Ⅰ和Ⅱ等因素无统计学差异。多因素分析发现肿瘤位置及术前血浆醛固酮浓度是影响术后高血压疗效的影响因素。结论肾上腺偶发瘤切除术后高血压有效改善率为67.36%。肿瘤位置及术前血浆醛固酮浓度对术后血压变化有影响,其中肿瘤位于右侧术后高血压改善情况更好,术前血浆醛固酮浓度值越大术后高血压改善情况更好。
[Abstract]:Objective to study the improvement of hypertension after adrenal incidental tumor resection and analyze the related factors. Methods 144 cases of adrenal incidental tumor with hypertension were collected and analyzed. According to the changes of blood pressure after operation, the patients were divided into effective group and ineffective group. The difference of clinical data between the two groups was compared and univariate and multivariate analysis was carried out. Results the changes of blood pressure before and after operation were compared. Postoperative hypertension was effectively improved in 97 cases (67.36 cases), among which 31 cases were normal and 21.53 cases were normal, 66 cases were improved 45.83%. According to the blood pressure, the patients were divided into three groups: grade 1, grade 2 and grade 3. The improvement rate of hypertension after operation was 72.13% and 66.03%, respectively. Univariate analysis showed that the location of tumor and plasma aldosterone concentration had influence on blood pressure after operation (P 0.05), but sex, age, tumor size, preoperative blood pressure, course of hypertension. The course of adrenal incidental tumor, diabetes mellitus, preoperative serum potassium, preoperative plasma cortisol concentration, preoperative adrenocorticotropic hormone (ACTH), preoperative urine vanillin mandelic acid (VMA). The multivariate analysis showed that the location of tumor and plasma aldosterone concentration before operation were the factors influencing the curative effect of hypertension after resection of adrenal contingent tumor. Conclusion the results of multivariate analysis showed that the tumor location and plasma aldosterone concentration were the main factors influencing the curative effect of hypertension after resection of adrenal contingent tumor. The effective improvement rate of blood pressure was 67.36.The location of tumor and the concentration of plasma aldosterone had influence on blood pressure after operation. The improvement of postoperative hypertension was better than that of preoperative plasma aldosterone concentration.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R736.6

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