肾上腺术后肾上腺皮质危象12例报告

目的提高对肾上腺切除术后肾上腺危象的预防和诊治水平。方法回顾性分析单侧肾上腺切除术后,发生肾上腺危象12例的资料。结果男5例,女7例。年龄17～55岁,平均37.2岁。发生肾上腺危象的12例肾上腺占位病例中,柯兴氏腺瘤3例,醛固酮瘤4例,嗜铬细胞瘤2例,肾上腺髓质脂肪瘤2例,肾上腺皮质增生1例。发生神智改变12例,心率增快12例,高热伴少尿8例,低血压休克1例,其他不典型症状5例。实验室检查提示重度低钠12例,低钾8例,高血糖9例。所有病例经补充糖皮质激素、维持电解质平衡等对症治疗后均治愈,无死亡病例。结论肾上腺危象病情危急凶险,及时诊断和治疗是关键,提高认识和积极预防尤为重要。

Report of adrenal crisis after epinephroectomy

Objective To improve prevention and treatment of adrenal crisis after adrenalectomy.Methods Restrospectively analyzed 12 patients with adrenal crisis after resection of unilateral adrenal.Results Of 12 patients,5 cases were male,7 cases were female.All cases were at the age of 17~55 years old,average 37.2 years old.Adrenal crisis in 12 cases of adrenal tumors,Cushing’s adenoma in 3 cases,4 cases of pheochromocytoma,Adrenal medullary lipoma in 2 cases,2 cases of adrenal myelolipoma,1 case of adrenal cortical hyperplasia.Occurrence of altered consciousness in 12 cases,heart rate increased in 12 cases,8 cases of fever with oliguria,hypotension and shock in 1 case,other atypical symptoms in 5 cases.Laboratory examination suggestive of severe hyponatremia in 12 cases,hypokalemia in 8 cases and hyperglycemia in 9 cases.After the supplement of glucocorticoid,maintaining electrolyte balance and symptomatic treatment,all cases were good cured,no death case.Conclusions Adrenal crisis is critical,to prompt diagnosis and treatment is the key,and to raise awareness and active prevention is particularly important.