本文選題：原發(fā)性醛固酮增多癥 + 醛固酮腺瘤��； 參考：《中國(guó)微創(chuàng)外科雜志》2017年03期

【摘要】：目的比較后腹腔鏡下腎上腺部分切除(partial adrenalectomy,PA)與全部切除(total adrenalectomy,TA)治療單側(cè)醛固酮腺瘤(aldosterone-producing adenoma,APA)的療效。方法 2006年1月~2012年12月,47例單側(cè)APA接受手術(shù)治療,其中36例行后腹腔鏡下腎上腺部分切除術(shù)(PA組),11例行后腹腔鏡下腎上腺全部切除術(shù)(TA組),比較2組患者術(shù)后血漿醛固酮濃度、血鉀水平、血壓水平、服用降壓藥物種類(lèi)。結(jié)果均無(wú)術(shù)中輸血及中轉(zhuǎn)開(kāi)腹。PA組和TA組手術(shù)時(shí)間分別為(116.5±37.0)、(100.2±42.8)min,無(wú)統(tǒng)計(jì)學(xué)差異(t=1.233,P=0.224);術(shù)中出血量中位數(shù)分別為30 ml(5~400 ml)、20 ml(10~300 ml),差異無(wú)統(tǒng)計(jì)學(xué)意義(Z=-1.267,P=0.205);禁食時(shí)間分別為(1.7±0.7)、(1.7±0.6)d,差異無(wú)統(tǒng)計(jì)學(xué)意義(t=0.000,P=1.000);拔引流管時(shí)間分別為(3.0±0.8)、(2.8±0.9)d,差異無(wú)統(tǒng)計(jì)學(xué)意義(t=0.705,P=0.484);術(shù)后住院時(shí)間分別為(8.2±2.2)、(8.1±2.0)d,差異無(wú)統(tǒng)計(jì)學(xué)意義(t=0.135,P=0.894)。47例隨訪6~97個(gè)月(平均30個(gè)月),術(shù)后均無(wú)復(fù)發(fā),無(wú)須補(bǔ)充血鉀;2組患者高血壓治愈率、改善率、無(wú)效率分別為(61.1%、25.0%、13.9%)和(63.6%、36.4%、0),差異無(wú)統(tǒng)計(jì)學(xué)意義(Z=-0.437,P=0.662)。結(jié)論對(duì)單側(cè)腎上腺APA的手術(shù)治療,后腹腔鏡下PA技術(shù)上安全可行,療效等同TA。
[Abstract]:Objective to compare the efficacy of partial adrenalectomy (PAA) with total adrenalectomy (TAA) in the treatment of unilateral aldosterone-producing adenomatous adenoma (APA). Methods from January 2006 to December 2012, 47 patients with unilateral APA underwent surgical treatment. Among them, 36 cases underwent retroperitoneal partial adrenalectomy and 11 cases underwent retroperitoneal total adrenalectomy. The plasma aldosterone concentration, blood potassium level, blood pressure level and the type of antihypertensive drugs were compared between the two groups. Results the operative time of no intraoperative blood transfusion and conversion to laparotomy in PA group and TA group were 116.5 鹵37.0 ~ 100.2 鹵42.8 minutes, respectively, and there was no significant difference in the mean intraoperative blood loss of 30 ml(5~400 / L ~ (20) ml(10~300 / min, respectively. The mean time of fasting was 1.7 鹵0.71.7 鹵0.6 ~ (th) d, with no significant difference in the mean intraoperative bleeding volume of 30 ml(5~400 / L ~ (-1. 267) P ~ (+) P ~ (0. 205) and no significant difference in fasting time (n = 1. 7 鹵0. 77 鹵0. 6 鹵0. 6d), respectively. There was no significant difference in the length of postoperative hospital stay (8.2 鹵2.2) and the postoperative hospitalization time was 8.2 鹵2.2 鹵2.0 days, and there was no significant difference (mean 30 months) between 47 cases followed up for 6 ~ 97 months (mean 30 months), while the postoperative hospitalization time was 8. 2 鹵2. 2 鹵2. 01 鹵2. 0 days, there was no significant difference in the mean follow-up time between 6 to 97 months (mean 30 months), and there was no recurrence after the operation, and the postoperative hospitalization time was 8. 1 鹵2. 0 鹵2. 0 days, and there was no significant difference between the two groups in the mean follow-up period of 6 ~ 97 months (mean 30 months). The cure rate and improvement rate of hypertension were 61.1% and 36.4%, respectively, and the ineffective rates were 61.1% and 63.6% respectively. There was no significant difference between the two groups. There was no significant difference between the two groups. Conclusion in the surgical treatment of unilateral adrenal APA, PA under retroperitoneal laparoscopy is safe and feasible, and the curative effect is the same as that of TAA.
【作者單位】： 第二軍醫(yī)大學(xué)廣州臨床醫(yī)學(xué)院廣州軍區(qū)廣州總醫(yī)院泌尿外科;
【基金】：國(guó)家自然科學(xué)基金(項(xiàng)目編號(hào):81172421)
【分類(lèi)號(hào)】：R699.3

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