本文關(guān)鍵詞： 腎上腺偶發(fā)瘤 高血壓 療效　出處：《大連醫(yī)科大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的研究腎上腺偶發(fā)瘤切除術(shù)后高血壓改善情況,分析相關(guān)影響因素。方法收集整理腎上腺偶發(fā)瘤伴高血壓臨床資料144例,根據(jù)術(shù)后血壓變化分為有效組和無(wú)效組,比較兩組臨床資料差異并進(jìn)行單因素及多因素分析。結(jié)果比較術(shù)前、術(shù)后血壓變化情況,術(shù)后高血壓有效改善為97例(67.36%),其中正常31例(21.53%),好轉(zhuǎn)66例(45.83%);無(wú)效47例(32.64%)。術(shù)前依據(jù)血壓情況分為1級(jí)、2級(jí)、3級(jí)三組,術(shù)后高血壓改善率分別為72.13%、66.03%、60%。單因素分析發(fā)現(xiàn)腫瘤位置及術(shù)前血漿醛固酮濃度對(duì)術(shù)后血壓變化有影響(P0.05),而性別、年齡、腫瘤大小、術(shù)前血壓、高血壓病程、腎上腺偶發(fā)瘤病程、是否合并糖尿病、術(shù)前血鉀、術(shù)前血漿皮質(zhì)醇濃度、術(shù)前促腎上腺皮質(zhì)激素(ACTH)、術(shù)前尿香草基扁桃酸(尿VMA)、術(shù)前血管緊張素Ⅰ和Ⅱ等因素?zé)o統(tǒng)計(jì)學(xué)差異。多因素分析發(fā)現(xiàn)腫瘤位置及術(shù)前血漿醛固酮濃度是影響術(shù)后高血壓療效的影響因素。結(jié)論腎上腺偶發(fā)瘤切除術(shù)后高血壓有效改善率為67.36%。腫瘤位置及術(shù)前血漿醛固酮濃度對(duì)術(shù)后血壓變化有影響,其中腫瘤位于右側(cè)術(shù)后高血壓改善情況更好,術(shù)前血漿醛固酮濃度值越大術(shù)后高血壓改善情況更好。
[Abstract]:Objective to study the improvement of hypertension after adrenal incidental tumor resection and analyze the related factors. Methods 144 cases of adrenal incidental tumor with hypertension were collected and analyzed. According to the changes of blood pressure after operation, the patients were divided into effective group and ineffective group. The difference of clinical data between the two groups was compared and univariate and multivariate analysis was carried out. Results the changes of blood pressure before and after operation were compared. Postoperative hypertension was effectively improved in 97 cases (67.36 cases), among which 31 cases were normal and 21.53 cases were normal, 66 cases were improved 45.83%. According to the blood pressure, the patients were divided into three groups: grade 1, grade 2 and grade 3. The improvement rate of hypertension after operation was 72.13% and 66.03%, respectively. Univariate analysis showed that the location of tumor and plasma aldosterone concentration had influence on blood pressure after operation (P 0.05), but sex, age, tumor size, preoperative blood pressure, course of hypertension. The course of adrenal incidental tumor, diabetes mellitus, preoperative serum potassium, preoperative plasma cortisol concentration, preoperative adrenocorticotropic hormone (ACTH), preoperative urine vanillin mandelic acid (VMA). The multivariate analysis showed that the location of tumor and plasma aldosterone concentration before operation were the factors influencing the curative effect of hypertension after resection of adrenal contingent tumor. Conclusion the results of multivariate analysis showed that the tumor location and plasma aldosterone concentration were the main factors influencing the curative effect of hypertension after resection of adrenal contingent tumor. The effective improvement rate of blood pressure was 67.36.The location of tumor and the concentration of plasma aldosterone had influence on blood pressure after operation. The improvement of postoperative hypertension was better than that of preoperative plasma aldosterone concentration.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R736.6

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本文編號(hào)：1470998