摘要
目的 探讨原发性醛固酮增多症（primary aldosteronism,PA）的诊治. 方法 对2008-01～2013-04收治的90例PA手术患者的临床资料进行回顾性分析. 结果 血压升高者89例,血钾降低者88例.醛固酮和肾素活性比值（ARR）＞25者占65.56％,ARR＞50者占58.89％.CT、MRI及B超检查发现肾上腺病变阳性率分别为98.89％、94.12％、73.44％.86例行腹腔镜手术（另外4例行开放性手术）.单侧腺瘤79例,单侧增生8例,双侧腺瘤1例,一侧腺瘤伴对侧增生1例,假性囊肿1例.单侧腺瘤中,51例行肿瘤剜除术,15例行肾上腺部分切除术,13例行肾上腺切除术.术后1周患者血压恢复正常者69例,血钾恢复正常者74例. 结论 ARR是PA定性诊断的主要方法;CT是PA定位诊断的主要方法;腹腔镜手术是治疗PA的主要方法.
Objective To evaluate the diagnosis and treatment of primary aldosteronism（PA）.Methods The clinical data of 90 PA patients from January 2008 to April 2013 were retrospectively analyzed.Results Of 90 patients,89 had hypertension,and 88 had hypokalemia.Patients with ALD/PRA ratio（ARR） ＞ 25 accounted for 65.56％,and patients with ARR ＞ 50 accounted for 58.89％.The positive rates of adrenal hyperplasia or adenoma detected by CT,MRI or B ultrasonography were 98.89％,94.12％ and 73.44％,respectively.Of 90 patients,86 were performed laparoscopic operation.Of 90 patients,there was 79 patients with unilateral adenoma,8 patients with unilateral hyperplasia,one patient with bilateral adenoma,one patient with adenoma and hyperplasia,and one patient with pseudocyst.For unilateral adenoma patients,51 underwent tumor enucleation,15 underwent partial adrenalectomy and 13 underwent adrenalectomy.The blood pressure in 69 patients and the blood potassium in 74 patients were normalized one week after the surgery.Conclusion ARR test is the main method of PA qualitative diagnosis.CT is the main method of PA positioning diagnosis.Laparoscopic operation is the main treatment for PA.
出处
《山西医科大学学报》
CAS
2013年第10期803-806,共4页
Journal of Shanxi Medical University
