肾上腺出血的诊治(附7例报告)

目的:探讨肾上腺出血的临床特征,提高对肾上腺出血的诊治水平。方法:回顾性分析1989~2005年经手术和病理检查证实的7例肾上腺出血患者的临床资料。结果:7例肾上腺出血患者临床表现多样,无特征性,肾上腺功能均正常。B超检查7例,4例表现为囊性肿物,其内可见点状、分隔样强回声肿块,3例表现为低回声肿块。5例行CT检查,4例报告为囊性肿块,1例报告为实质性肿块,增强CT扫描均无强化。MRI检查2例,显示肾上腺区不均匀肿物,T1加权为等信号,T2加权为低信号。行患侧肾上腺及肿物切除4例,行患侧部分肾上腺及肿物切除3例。术后肾上腺皮质功能正常,随访3个月~2年,无肾上腺皮质功能低下表现。结论:肾上腺出血术前诊断困难,B超、CT、MRI对诊断有一定价值。对双侧肾上腺出血或单侧肾上腺出血且血肿>5 cm者应采取手术治疗。

Diagnosis and treatment of adrenal hemorrhage (Report of 7 cases)

Objective:To describe the clinical feature of adrenal hemorrhage and improve the diagnosis and treatment for this disease.Methods:Clinical data of 7 cases of patients with adrenal hemorrhage confirmed by surgery and pathology between 1989 and 2005were reviewed and studied.Results:The adrenal hemorrhage in all the 7 cases was unilateral with various clinical manifestations.The functions of adrenal gland were all normal.In 7 cases who underwent ultrasound examination,cystic masses with strong echo of point or partition had been noticed in 4 cases and low echo of masses had been detected in 3 cases.Five cases underwent CT scan,of which 4 cases displaying cystic masses and 1 case dispaying mass.Two cases underwent MRI,which displaying uneven masses in adrenal gland.The hemorrhage was iso-signal in T1-weighted and low signal in T2-weighted image.Four cases underwent resection of adrenal gland and masses;three cases underwent partial resection of adrenal gland and masses.The function of adrenal cortex were all normal during the follow up of 3 months to two years.Conclusions:Preoperative diagnosis of the adrenal hemorrhage is difficult and US,CT and MRI are helpful for the diagnosis.The indication for surgery is biliteral adrenal hemorrhage or the uniliteral hematoma exceeds 5 cm in diameter.