无功能肾上腺偶发瘤切除对血压的影响

Effect of surgical treatment of non-functional incidental suprarenoma on blood pressure

目的探讨应用后腹腔镜切除无功能肾上腺偶发瘤对血压的影响。方法选取2012-10至2014-10肾上腺瘤合并高血压,并行后腹腔镜瘤切除92例,并进行最长2年的随访观察,观察术前至术后完成随访的血压变化情况,以及手术相关并发症发生的情况。结果共计78例完成随访。术后至完成随访期间共有69例(88.5%)高血压情况得到改善,收缩压水平由术前(167.2±5.2)mm Hg降至术后随访终点(122.1±3.7)mm Hg,舒张压(100.3±4.6)mm Hg降至术后(79.9±2.4)mmHg,差异有统计学意义(P<0.001);初始血压为高血压3、2、1级的患者术后血压总体改善率分别为93.1%、88.9%、88.1%,差异无统计学意义;共发生手术并发症11例(14.1%),均无需特殊处理。结论后腹腔镜切除肾上腺瘤能够改善一部分患者的血压水平,且手术风险较低。

Objective To investigate the effect of retroperitoneal laparoscopy of non-functional incidental suprarenoma on hypertension. Methods Retrospective analysis was done from 2012 October to 2014 October,and patients with adrenal tumor undergoing retroperitoneal laparoscopic resection were as the research objects. The longest follow-up time was 2 years. We observed blood pressure change from preoperation to completion of postoperative follow-up,and operation-related complications. Results During the postoperative follow-up to completion,the blood pressure in 69 patients decreased（ 88. 5%,69 /78）. The average systolic blood pressure levels decreased from（ 167. 2 ± 5. 2） mm Hg to（ 122. 1 ± 3. 7） mm Hg,and the average diastolic blood pressure levels decreased from（ 100. 3 ± 4. 6） mm Hg to（ 79. 9 ± 2. 4） mm Hg,and the difference was statistically significant（ P 〈0. 001）. In patients with initial hypertension at levels 3,2,1,their postoperative overall improvement rate were 93. 1%,88. 9%,88. 1%,and the differences were no statistically significant. Furthermore,the operation had a low incidence of complications（ 11 cases,14. 1%）,not needing medical treatment. Conclusions Retroperitoneal laparoscopic resection of adrenal tumor can relieve a portion of patients with hypertension,and the risk of operation is low.