单侧肾上腺结节样增生手术治疗的可行性研究

Feasibility study of the surgical treatment for unilateral adrenal nodular hyperplasia

目的探讨单侧肾上腺结节样增生CT检查的准确性及手术治疗的可行性。方法回顾性分析经手术病理证实的9例单侧肾上腺结节样增生的临床和CT资料,统计术前CT的误诊率,并随访其术后症状控制、血压以及血钾改善情况。结果共收集醛固酮腺瘤患者168例,其中术后病理证实为结节样增生的患者9例,以肾上腺CT醛固酮腺瘤最大直径分组,<10mm组CT误诊率为33.33%,≥10mm组为4.32%。8例单侧肾上腺结节样增生患者术后乏力、手麻、手足搐愵等症状消失;6例术后血压恢复正常,2例术后血压好转;7例血钾恢复正常,1例低钾较前好转。结论 (1)肾上腺CT检查的特异性低,误诊率高,尤其是对于小于10mm的病灶。(2)单侧肾上腺结节样增生手术治疗效果好,可以达到根治的目的。

Objective To investigate the accuracy of CT scan and the feasibility of surgical treatment for the unilateral adrenal nodular hyperplasia （UAH）.Methods The clinical and CT data of 9 cases of surgical pathology confirmed unilateral adrenal nodular hyperplasia was retrospectively analyzed.The preoperative CT misdiagnosis rate was statistically analyzed,and the symptom control,blood pressure and serum potassium level after operation were recorded.Results A total of 168 cases of aldosterone adenoma were collected,of which 9 were pathologically diagnosed as nodular hyperplasia.All patients were divided into two groups by aldosterone adenoma CT maximum diameter,＜10 mm group and ≥ 10 mm group.The misdiagnosis rate of CT was 33.33％ in ＜10 mm group and 4.32％ in ≥10 mm group.The postoperative symptoms as fatigue,hand numbness disappeared in 8 cases,blood pressure returned to normal in 6 cases,blood pressure improved in 2 cases,potassium returned to normal in 7 cases,and low potassium improved in 1 case.Conclusion Adrenal CT scan has low specificity,high misdiagnosis rate,especially for less than 10 mm lesions.Surgical treatment for UAH has good effect,and could achieve the purpose of cure.