嗜铬细胞瘤175例临床分析

目的探讨嗜铬细胞瘤的诊断和治疗。方法对175例嗜铬细胞瘤进行了回顾性分析,其中肾上腺嗜铬细胞瘤145例,肾上腺外嗜铬细胞瘤27例。有典型儿茶酚胺症临床表现者166例,24 h尿VMA阳性率为86.3%,B超、CT定位诊断率分别为95.9%及94.3%。结果170例行开放手术切除肿瘤,5例经后腹腔镜切除肿瘤。全组均经病理证实为嗜铬细胞瘤,其中良性163例,恶性12例,无手术死亡病例。结论嗜铬细胞瘤主要依据临床表现、生化定性检查及影像学定位检查明确诊断,术前准备极为重要,术中应严密监测和处理血压波动,同时应重视预防及正确处理手术并发症。

Clinical analysis of 175 cases of phechromocytoma

Objective To investigate the diagnosis and treatment of phechromocytoma.Methods A retrospective analysis of 175 patients with phechromocytoma was carried out.145 tumors were intraadrenal and 27 extraadrenal.166 cases had high blood catecholamine.Urinary Vanillyl-mandelic acid(VMA) was the best marker with a positive sensitivity rate of 86.3%.The accurate localization rate of the tumors was 95.9% by ultrasonography,and 94.3% by CT.Results Open excision of tumor was carried out in 170 cases and laparoscopic adrenalectomy in 5 cases.Operative therapy was successful in all cases.The diagnosis of all cases was confirmed by pathologic studies.163 cases were benign and other 12 cases were malignant.Conclusion The procedures of qualitative and locative diagnoses of phechromocytoma include clinical manifestations,urinary VMA assessment and imaging investigation.Preoperative management was extremely important.Fluctuation of blood pressure has to be monitored during surgery and treated carefully and promptly.In addition,the prevention and correct management of operative complication is also important.