卵巢颗粒细胞瘤20例临床分析

颗粒细胞瘤是最常见的一种卵巢性索间质肿瘤，具有分泌雌激素的特点，被认为是低度恶性肿瘤，预后一般较好，但有晚期复发或转移倾向。作者收集1985～1992年间我院收治的卵巢颗粒细胞瘤20例进行分析和讨论。临床资料ZO例发病年龄为17～69岁，平均42．5岁。左侧9例，右侧8例，双     

铬作业工人尿NAG同功酶活性变化的探讨

本文调查了９８名铬作业工人，发现尿ＮＡＧ－Ｂ明显升高，尿ＮＡＧ－Ａ显著低于对照组，出现ＮＡＧ－Ａ／ＮＡＧ－Ｂ比值倒置（１：４，正常为３：２）。铬作业工人尿ＮＡＧ－Ｂ在尿蛋白和尿β２－ＭＧ均在正常范围时，已开始显著高于对照组，并随肾损害程度加重而明显增加，提示尿ＮＡＧ－Ｂ可能为检测铬性肾损害较灵敏的指标。尿ＮＡＧ－Ａ虽显著低于对照组，但与尿蛋白和尿β２－ＭＧ无明显相关关系（ｒ均小于０．１８，Ｐ＞０．     

大鼠注射不同剂量铬对血清、脏器铬分布的影响

大鼠注射不同剂量铬对血清、脏器铬分布的影响杨晓霞，相有章，边建朝，宋术亮，叶平（山东省地方病防治研究所，济南２５００１４）关键词：铬，血清，脏器ＥｆｆｅｃｔｏｆＩｎｔｒａｐｅｒｉｔｏｎｅａｌＩｎｊｅｃｔｉｏｎｏｆＤｉｆｆｅｒｅｎｔＤｏｓｅｓｏｆＣｈｒ...     

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.     

后腹腔镜手术治疗嗜铬细胞瘤

目的探讨后腹腔镜手术治疗嗜铬细胞瘤的适应证及手术安全性. 方法采用后腹腔镜手术治疗肾上腺嗜铬细胞瘤患者15例(双侧2例),腹主动脉旁嗜铬细胞瘤1例.对照组为开放手术治疗的肾上腺嗜铬细胞瘤16例,腹主动脉旁嗜铬细胞瘤1例.结果后腹腔镜手术组16例患者行后腹腔镜手术18例次,17例次取得成功,1例因术中出血改行开放手术.肿瘤最大径2.0～6.5(3.8±1.6)cm.手术时间45～150(85±31)min,出血量10～100(32±22)ml.术后吗啡用量0～40(12.5±7.8)mg;术后恢复进食时间1～3(1.8±0.7)d;下床活动时间2～3(2.3±0.5)d;术后住院时间4～9(6.5±1.3)d.开放手术组肿瘤最大径1.5～6.0(4.3±1.3)cm.手术时间90～240(155±39)min,出血量50～600(273±105)ml,9例输血.术后吗啡用量10～120(61±24)mg;术后恢复进食时间2～4(2.9±0.5)d;术后下床活动时间3～6(4.8±0.7)d;术后住院时间8～11(8.8±0.9)d.结论对于有一定腹腔镜手术经验者,后腹腔镜手术并不增加嗜铬细胞瘤手术的危险性,且具有手术时间短、出血少、创伤小、疼痛轻、康复快等优点.该法有望成为治疗肾上腺嗜铬细胞瘤的首选手术方法.     

嗜铬细胞瘤围手术期监护

嗜铬细胞瘤好发于肾上腺髓质．少数亦可发生于交感神经系统的其它部位。由其引起的高血压极富有戏剧性变化，病情变幻莫测，手术切除嗜铬细胞瘤是最有效的治疗方法。但因其疾病的特殊性，手术具有相当的风险。做好围手术期监护是提高手术成功率的关键。我院自1987—2002年以来共收治嗜铬细胞病人53例，现将嗜铬细胞瘤围手术期监护报告如下：     

恶性纤维组织细胞瘤的诊疗进展

近年来恶性纤维组织细胞瘤的发病率正逐年上升并日益受到重视，本就其诊断和治疗的研究进展作一简要综述。     

桡腕关节重建治疗桡骨下端骨巨细胞瘤

目的探讨自体腓骨移植在桡腕关节重建术中的应用价值.方法应用带关节囊腓骨近端移植修复桡骨远端骨巨细胞瘤因瘤段切除后的骨缺损,游离移植4例,带血管蒂移植3例.结果所有被修复骨缺损均良好愈合,腕关节功能与外观令人满意.结论自体腓骨移植是修复桡骨远端缺损的理想供本,操作安全、有效、合并症少.