排序方式: 共有15条查询结果,搜索用时 546 毫秒
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目的:总结后腹腔镜手术治疗肾上腺肿瘤的临床应用价值及手术方法。方法:回顾分析2008年1月至2012年6月为62例肾上腺肿瘤患者行后腹腔镜手术的临床资料,其中皮质醇腺瘤29例,醛固酮腺瘤22例,嗜铬细胞瘤8例,髓样脂肪瘤3例。结果:62例均顺利完成后腹腔镜手术。手术时间平均(65±14.6)min,出血量平均(78±19.1)ml,术中、术后均未输血。术后平均住院(4.5±0.9)d,无明显并发症发生。术后平均随访(21±4.7)个月,未见复发。结论:后腹腔镜手术治疗肾上腺肿瘤具有患者创伤小、出血少、康复快、并发症少等优点,具有良好的临床应用价值。 相似文献
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目的:评估年龄小于40岁,PSA大于10ng/ml的患者,活检发现前列腺癌的情况.方法:32位患者,年龄小于40岁,PSA大于10ng/ml.3位前列腺炎患者被排除.剩下的29位患者行指检,并且做在超声引导下作前列腺的活检.结果:29位患者的平均年龄为35岁(28~40岁);PSA的平均数为12.25ng/ml(10.00~15.58ng/ml).第一次活检的结果是:前列腺癌2例(6.90%);增生24例(82.76%);2例炎症患者(6.90%),1例HGPIN(3.45%).增生患者中的18位行第二次活检,皆为增生.18例患者行第三次活检,都是增生.结论:年龄小于40岁而PSA大于10ng/ml的患者,发现前列腺癌还是比较低的(6.90%).对于长时间PSA升高的患者,活检并不推荐. 相似文献
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经尿道前列腺电切术(TURP),目前已成为治疗老年前列腺增生的重要手段,其优点为手术创伤小,术后恢复快,易于为患者接受,但接受手术患者大部分为老年人,常合并不同程度的心肺疾患,对于手术的耐受及术中术后应激能力均相对较低,且术中应用大量5%甘露醇冲洗液,长时间截石体位等,给麻醉管理带来一定困难。我院自2000年以来,在硬-腰联合麻醉下,行TURP术210例,取得满意疗效,现总结如下。[第一段] 相似文献
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嗜铬细胞瘤诊疗:单中心142例报告 总被引:1,自引:1,他引:0
目的 提高嗜铬细胞瘤的诊疗水平.方法 回顾性分析2002年8月至2010年2月手术治疗的142例患者145例次病理确诊嗜铬细胞瘤临床资料,并对术后近期高血压恢复情况及远期肿瘤复发情况进行随访.肿瘤直径1.3~18.0 cm,平均5.9 cm,位于肾上腺内的单发肿瘤117例,双侧肿瘤10例,异位肿瘤10例,肾上腺及肾上腺外同时存在肿瘤5例.有典型儿茶酚胺症状者98例(69.0%),隐匿型嗜铬细胞瘤44例(31.0%).术前给予酚苄明或甲磺酸多沙唑嗪准备l周以上.142例患者行手术145例次,开放手术91例次,腹腔镜54例次. 结果 142例术后病理均为嗜铬细胞瘤,其中良性83例、恶性23例、可疑恶性36例.术中血压骤增与术前血儿茶酚胺水平相关,与术前血压、术前应用a受体阻滞剂时间长短及肿瘤大小无关.术后高血压症状缓解87例,11例仍需药物控制血压.围手术期死亡1例.术后91例随访3~96个月,中位时间46个月,复发转移10例,其中5年内死于肿瘤复发转移6例. 结论嗜铬细胞瘤确诊主要依据临床表现、生化定性检查及影像学定位检查,手术切除肿瘤是嗜铬细胞瘤的根治方法,对于术前血儿茶酚胺水平明显升高的患者更应警惕术中血压变化,术前应给予更充分的准备.Abstract: Objective To review the experience in diagnosis and treatment of pheochromocytoma in a single center. Methods A total number of 142/145 pheochromocytoma cases treated surgically in our institute from August 2002 to February 2010 were retrospectively reviewed. The mean diameter of tumor was 5.9 cm (1.3- 18. 0 cm). The majority of the tumors (92.9%) were adrenal pheochromocytomas. Ninety-eight patients (69.0 % ) presented initially with hypertension, whereas 44 patients (31%)presented with adrenal incidentaloma. A specific anti-hypertensive pre-surgery preparation with phenoxybenzamine or doxazosine mesylate was started over 1 week before the operation.Of the 142 patients, 91 accepted open surgery, 54 accepted laparoscopic surgery, of which, 5 converted from laparoscopic surgery to open surgery. Results Histopathological results showed that all the cases were pheochromocytoma, while 83 cases were benign, 23 cases were malignant and 37 cases were suspected malignant. Sudden rising of blood pressure during operation was related to the preoperative serum level of catecholamine. Eighty-seven of 98 patients with preoperative hypertension had normal postoperative blood pressure; the remaining 11 patients reduced the dosage of anti-hypertension medication postoperatively. During the follow-up of 3-96 months (median 46 months), 10 of 91patients had a recurrence or metastasis. Six patients died of recurrences or metastasis within 5 years.Conclusions The procedures of qualitative and locative diagnosis of phechromocytoma include clinical manifestations, biochemical tests and imaging investigation. Surgical excision is the fundamental treatment for cure. Patients with high serum level of catecholamine tend to have a sudden rising of blood pressure during operation. Preoperative management is extremely important for the safety of the patient. Intensive follow up is necessary. 相似文献
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