250例肾上腺肿瘤临床分析

目的总结250例肾上腺肿瘤的诊断和治疗经验。方法回顾分析250例肾上腺肿瘤的临床资料。结果醛固酮腺瘤（APA）163例腺瘤切除术后乏力、夜尿增多等症状消失148例（90%）,血压恢复正常136例（83.4%）。嗜铬细胞瘤（PHEO）47例,43例切除肿瘤术后头痛、多汗、心悸等症状消失32例（74.6%）,血压正常31例（72%）,其中2例恶性嗜铬细胞瘤术后1.3年死亡。库兴综合征（CS）（腺瘤型）17例术后半年向心性肥胖等症状消失,血压恢复正常。8例肾上腺皮质癌（ACC）和3例肾上腺转移癌术后0.5~3年因肿瘤转移死亡。3例肾上腺髓样脂肪瘤术后1年复查,肿块未复发。3例节细胞神经瘤术后头痛等症状消失,血压正常,4例嗜铬细胞瘤合并严重心肺疾病和6例肾上腺转移癌未手术。结论肾上腺最常见的肿瘤是醛固酮腺瘤和嗜铬细胞瘤,内分泌检查可定性,定位检查首选CT。良性功能性肾上腺肿瘤手术可治愈。

Clinical analysis of adrenal tumor in 250 cases

Objective To summerize the diagnostic and therapeutic experience of 250 cases of adrenal tumors.Methods Clinical data of 250 cases of adrenal tumors were retrospectively analysed.Results After adenoma resection in 163 aldosterone-producing adenoma（APA）patients,symptoms such as debilitation and consuria disappeared in 148 cases（90%）,and 136 patients＇ blood pressure became normal（83.4%）.After tumorectomy in 43 pheochromocytoma（PHEO）patients,symtoms such as headache,hyperhidrosis and cardiopalmus disappeared in 32 cases（74.6%）,and blood pressure became normal in 31 cases（72%）,but 2 cases of malignant PHEO died 1 year after operation.After operation,symptom such as central obesity disappeared and blood pressure became normal in 17 cases with Cushing＇s syndrome（CS）.8 cases of adrenocortical carcinoma（ACC）and 3 cases of adrenergdrenic metastatic carcinoma died 0.5~3 years after operation.No recurrence was detected in the 3 cases of adrenal myelolipoma 1 year after operation.3 ganglioncuroma patients＇ symptoms such as headache dispeared,and blood pressure became normal.Conclusion The most common adrenal tumor is APA and PHEO.Endocrinology can be used to detect the adrenal tumor,while CT is the first choice for the localization of the tumor.Functional adrenal tumors can be cured by operation.