肾上腺组合性嗜铬细胞瘤四例报告及文献复习

Objective To discuss the clinical characteristics and management principles of com-posite pheochromoeytoma of adrenal gland (pheochromocytoma-ganglioneuroma). Methods Four cases of composite tumor of adrenal gland diagnosed pathologically were reviewed. All the cases were male, aged 37 to 62 years;three of them had the history of hypertension, one of them accompanied with paroxysmal palpitation, while one case was asymptomatic. Computerized tomography and ultra-sonography showed single tumor in adrenal, the diameter was about 2.5、3.8、6.3、15cm respectively. Two cases showed positive results in 131Ⅰ-metaiodobenzylguanidine (MIBG) scintigraphy. One case showed positive result in 99Tcm-hydrazinonicotinamide-3trysinoctreotide (HTOC) scintigraphy. Twenty-four hours urinary catecholamine examination revealed the average of norepinephrine, epi-nephrine and dopamine were (196.1±92.2)nmol/24 h, (26.6±8.9)nmol/24 h, (1957.9±913.5) nmol/24 h respectively. Two cases were at a little elevated level and the others with normal. All cases were managed with α-adrenergic receptor blocker preoperatively for 2-4 weeks. Results Tumor re-section was performed in all 4 cases, and 3 cases by retroperitoneal laparoscopy, one by open surgery. All 4 cases were diagnosed as composite pheochromocytoma of adrenal (Pheochromocytoma-gangli-oneuroma) by pathology. All patients had no evidence of recurrence or metastasis during follow-up from 15 to 38 months. Two of three cases with hypertension reverted to normotensive. Conclusions Composite pheochromocytoma of adrenal is rare, difficult to be diagnosed preoperatively. Except mild in eatecholamine secretion, which clinical manifestations are similar to pheochromocytoma. Pheochro-mocytoma-ganglioneuroma is no apparent tendency for aggressive behaviors, the results of surgical management are favorable.     

喜普妙致强迫性动作加重1例

报告1例喜普妙致强迫性动作加重如下:1　病例介绍患者女性,18岁,学生。因反复出现强迫性观念、强迫性行为2年入院。患者无诱因起病,表现为反复疑虑父母把不良的性格基因遗传给了她,经常在作文题目下反复划直线。明知没有意义而欲罢不能。并为此焦虑不安、痛苦万分,意志活动减退     

左室合并右室急性心肌梗死难治性休克2例

左室合并右室心肌梗死并非少见 ,但常被临床忽视并漏诊。合并心源性休克其早期诊断及采取相应的措施对疾病恢复至关重要。现将左室合并右室急性心肌梗死(ＡＭＩ)难治性休克 2例诊治体会报道如下。1　病例简介例 1:男 ,4 4岁 ,因持续性剧烈胸闷痛伴头晕大汗 3小时以“冠心病”收     

戈纳多瑞林诱导排卵

醋酸戈纳多瑞林(Gonadorelin acetate)是一种人工合成的十肽,其氨基酸顺序与人类促性腺激素释放激素(GnRH)完全相同,最近已由美国食品和药物管理局批准用于治疗原发性下丘脑性闭经。盐酸促性腺激素释放因子曾用于诊断,GnRH的类似物已用于子宫内膜异位和晚期前列腺癌的治疗。     

急性右室心肌梗塞25例抢救治疗体会

1996年10月-2006年10月,我们抢救急性右室心肌梗塞25例,现将治疗结果与体会进行回顾性分析,总结报告如下:     

高半胱氨酸血症心脏损害的诊治进展

近期研究表明，血浆高半胱氨酸浓度增高为一项独立的冠心病危险因素。本文阐述了其病因，发病机制，并就叶酸及B族维生素等有关治疗进行简要讨论。     

扩张型心肌病的室性心律失常

扩张型心肌病的室性心律失常北京医科大学第三医院心内科刘丽日本自治医科大学循环系内科中山敏夫，中岛纯子，夏田隆夫，柳沼淑夫自治医科大学中心生理机能检查室吉江和彦扩张型心肌病（ＤＣＭ）是以心室扩大和收缩不良为主要特征的病患。多以左室功能不全发病，难治性心...     

改良导丝颈内静脉插管法在急诊中的应用

1988年以来，我们采用带钢丝连续硬膜外导管（以下称改良导丝）代替导引钢丝作顿内静脉穿刺置管共316例（其中部分病例系取自援马里医疗队），成功率高，现报告如下。1改良导丝的制作取连续硬膜外导管（上海诊察医疗仪器厂）一根（带钢丝管芯），将其中钢丝管芯截去一段，恰比导管短5cm左右，然后再将钢丝管芯置入导管内，这样导管的前端有5cm左右无钢丝管芯，消毒后备用。2穿刺器械18号BD薄壁金属穿刺外、改良导丝、16GA外套管、5或10ml带穿刺针针简各一副。3临床资料本组共316例。男性139例，女性177例。置管成功311例，成功率98．4％。…