原发性醛固酮增多症pha84例的诊断及手术治疗经验

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1、英汉缩略语名词对照英文缩写英文全称中文全称PHAPrimaryhyperaldosteronism原发性醛固酮增多症ARRAldosterone-to-reninratio醛固酮/肾素比值AVSAdrenalveinsample肾上腺静脉取血美国ASAAmericanSocietyofAnesthesiology麻醉师协会电子计算机断层扫描特发性醛CTComputedTomography固酮增多症醛固酮腺IHAIdiopathichyperaldosteronism瘤原发性单侧肾上腺APAaldosteroneproducingadeno

2、ma皮质增生UNAHUnilateralnodularadrenalhyperplasiaFHFamilialhyperaldosteronism家族性醛1古1酮增多症原发性醛固酮增多症(PHA)84例的诊断及手术治疗经验摘要目的回顾总结原发性醛固酮增多症(primaryhyperaldosteronism,PHA)的诊断及治疗经验。方法回顾分析2009年1月至2013年12月在我院诊断为PHA患者84例，根据临床表现、血钾、24小时尿钾、血气分析、立位醛固酮与肾素比值(aldosterone-to-reninratio,ARR)>肾上腺

3、静脉取血(adrenalveinsample,AVS)^卡托普利抑制试验、CT定位检查及术后病理确诊为PHA,采用后腹腔镜肾上腺肿瘤切除术治疗，将患者分为典型临床表现组和不典型临床表现组；对比两组患者肿瘤大小、术前ASA(美国麻醉师协会)分级、手术时间、术中出血量、术前准备时间、术后住院时间。结果典型组与不典型组肿瘤最人径、手术时间、术后住院时间、术中出血量无显著差异(P〉0・05)；典型组和不典型组术前准备时间、术前ASA分级有显著差杲(P<0.001)o结论典型和不典型PHA诊断及治疗无差别；典型组较不典型组手术风险高，需要较长的术前

4、准备时间；AVS适用于早期PHA确诊或定位困难者。关键词：醛固酮增多症，典型，不典型，诊断，治疗THEEXPERIENCEOFTHEDIAGNOSISANDSURGICALTREATMENTOFPRIMARYALDOSTERONISM84CASESABSTRACTObjectivesToretrospectivelyreviewtheexperienceofthediagnosisandtreatmentofprimaryaldosteronism.MethodsWeretrospectivelyanalyzed84caseswithPH

5、AinourhospitalfromJanuary2009toDecember2013・Thepatientsweredividedintotwogroups,typicalpresentationgroup(59cases)andatypical-presentationgroup(25cases),whowerediagnosedwithadrenocorticaladenomasaccordingtotheclinicalmanifestations,serumpotassium,24-hoururinarypotassium,b

6、loodgasanalysis,supineanduprightaldosterone-to-reninratio(ARR),adrenalveinsample(AVS),Captoprilsuppressiontest,CTscansfortopographicdiagnosesandsurgicalfindingsforpathologicaldiagnoses・Withretroperitoneallaparoscopicadrenalectomytreatment.Thecomparisonofthetwogroupsintumo

7、rsize,preoperativeASAgrading,surgicaltime,intraoperativebloodloss,preoperativepreparationtime,postoperativehospitalstaywereanalyzed.ResultsAllofthe84caseswerediagnosedwithPHA.Nosignificantdifferenceinmaximumtumordiameters,surgicaltime,intraoperativebloodloss,postoperative

8、hospitalstaybetweenthetypical-andatypical-presentationgroups(P>0.05).Whilethepreoperativeprepara