肾上腺结节性增生41例分析

A clinical analysis of 41 cases of adrenal nodular hyperplasia

目的 提高肾上腺结节性增生的诊治水平。 方法 回顾性分析 2 0年收治肾上腺结节性增生 41例的资料。 结果 41例中左侧 32例 ,右侧 6例 ,双侧 3例。均经开放性手术和病理证实。 36例随访 3个月至 3年 ,5例失访。 2 6例术后 1个月血压恢复正常 ,头痛、头晕、向心性肥胖、乏力、性欲下降等症状明显好转。 2例于术后 2个月好转。 8例患者血压恢复不理想。 结论 B超和CT是诊断肾上腺结节性增生的主要方法 ,肾上腺结节性增生与腺瘤的鉴别诊断十分重要 ,外科手术是主要的治疗手段 ,影响疗效的因素与病史长、周身血管硬化有关。

Objective To present and evaluate the diagnosis and treatment of 41 cases of adrenal nodular hyperplasia. Methods From 1979 to 1999,41 cases of adrenal nodular hyperplasia were diagnosed and treated .The diagnosis was all ascertained on open surgery and pathologial studies. Results In the 41 cases,32 were on the left,6 on the right and 3 bilateral. The positive diagnosis rate of B ultrasonography was 85% and that of CT 93%.In 28 cases of the 41,the blood pressure dropped and the symtoms such as headache,dizzyiness,centric obesity,inertia and decrease of sexual desire have been significantly improved after surgery.In 8 of the cases,blood pressure didn't drop to normal after three months to three years. 5 cases have not been fellowed up. Conclusions B ultrasonography and CT scan play the important role in diagnosis. Compared with CT,MRI had no specific superiority.The differenital diagnosis of nodular hyperplasia and adrenal adenoma is very important.Open surgery is the main treatment method. Factors effecting the therapeutic outcome are the status of vascular sclerosis of the patient and the medical history.