嗜铬细胞瘤的诊治(附85例报告)

Diagnosis and treatment of pheochromocytoma (report of 85 cases)

目的 探讨嗜铬细胞瘤的诊断治疗。 方法 报告１９６７ ～１９９７ 年收治的８５ 例嗜铬细胞瘤。临床表现为高血压者７８ 例（９２ ％ ） ，７３ 例尿ＶＭＡ 检查，其中６８ 例高于正常，阳性率９３ ％ 。Ｂ超、ＣＴ 和ＭＲＩ定位诊断的阳性率分别为９０ ％ 、９６ ％ 和１００％ 。 结果 全部病例均经手术和病理证实，其中良性７７ 例（９１％ ） ，恶性８ 例（９ ％ ） ；肿瘤位于肾上腺７１ 例（８４％ ） ，异位嗜铬细胞瘤１４ 例（１６ ％ ） 。 结论 强调充分的术前准备。

Objective To evaluate the diagnostic and treatment procedures for pheochromocytoma. Methods 85 cases of pheochromocytoma diagnosed and treated between Dec.1967 and Dec.1997 were reviewed and studied.92% of the cases manifested hypertension.Urinary VMA,serum and urinary catecholamines were studied showing good sensitivity.Urinary VMA has been the best marker with a positive sensitivity of 93.0%.The accuracy rates of localization of B ultrasonography,computerized tomography and magnetic resonance imaging were 90%,96% and 100% respectively.Preoperative preparation with α adrenergic blocker for hypertension and β adrenergic blocker against arrhythmias were essential.The diagnosis of pheochromocytoma was confirmed on surgery and pathologic studies in all. Results In 77 cases (91%),the pheochromocytoma was benign and in the other 8 the tumor was malignant (9%).The tumor was located in the adrenal gland in 71 (84%),being on the left side in 27 (32%),on the right in 42 (49%) and bilateral in 2 (2%).In 14 cases (16%),the tumors were extraadrenal.Recurrance of the pheochromocytoma occurred in 4 with increased tendency of malignancy. Conclusions Surgical management was the only means for cure and preoperative preparation was extremely important.