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猫肾上腺皮质醛固酮分泌瘤的单侧肾上腺切除术治疗:10例(2002 - 2012年)

Treatment of aldosterone-secreting adrenocortical tumors in cats by unilateral adrenalectomy: 10 cases (2002-2012).

作者信息

Lo A J, Holt D E, Brown D C, Schlicksup M D, Orsher R J, Agnello K A

机构信息

Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA.

出版信息

J Vet Intern Med. 2014 Jan-Feb;28(1):137-43. doi: 10.1111/jvim.12186. Epub 2013 Dec 26.

Abstract

BACKGROUND

Primary hyperaldosteronism (PHA) in cats occurs as a consequence of excessive hormone production by an adrenocortical tumor. Median survival time, association between tumor type and prognosis, and the likelihood that cats require continued medical therapy after surgery have not been systematically evaluated.

OBJECTIVES

To determine the median survival time of cats with PHA treated by unilateral adrenalectomy. To examine if tumor type, anesthesia time, or tumor location (left or right side) affect survival and if affected cats require continued postoperative treatment for persistent hypertension or hypokalemia.

ANIMALS

Ten client-owned cats.

METHODS

Retrospective study. Cats were diagnosed with PHA based on clinical signs, increased plasma aldosterone concentration, and advanced imaging. Cats underwent unilateral adrenalectomy. Survival time (days alive after surgery) was determined for each cat. Factors affecting median survival time were investigated, including histopathology, anesthesia time, and location (side) of the tumor.

RESULTS

Eight of 10 cats survived to discharge from the hospital post adrenalectomy. Overall median survival was 1,297 days (range 2-1,582 days). The only significant factor affecting median survival time was anesthesia time >4 hours. Tumor type and location (side) did not significantly affect median survival time. No cats required continued medical treatment for PHA.

CONCLUSIONS AND CLINICAL IMPORTANCE

Although PHA in cats is still considered an uncommon condition, it should be considered in middle to older aged cats with hypokalemic polymyopathy and systemic hypertension. Surgical correction by unilateral adrenalectomy is a viable approach to definitive treatment of PHA with no need for continued medical management.

摘要

背景

猫的原发性醛固酮增多症(PHA)是肾上腺皮质肿瘤产生过量激素的结果。尚未对中位生存时间、肿瘤类型与预后之间的关联以及猫在手术后是否需要持续药物治疗的可能性进行系统评估。

目的

确定接受单侧肾上腺切除术治疗的PHA猫的中位生存时间。检查肿瘤类型、麻醉时间或肿瘤位置(左侧或右侧)是否影响生存,以及受影响的猫是否需要针对持续性高血压或低钾血症进行术后持续治疗。

动物

十只客户拥有的猫。

方法

回顾性研究。根据临床症状、血浆醛固酮浓度升高和先进的影像学检查诊断猫患有PHA。猫接受单侧肾上腺切除术。确定每只猫的生存时间(手术后存活天数)。研究影响中位生存时间的因素,包括组织病理学、麻醉时间和肿瘤位置(侧别)。

结果

10只猫中有8只在肾上腺切除术后存活至出院。总体中位生存时间为1297天(范围2 - 1582天)。影响中位生存时间的唯一显著因素是麻醉时间>4小时。肿瘤类型和位置(侧别)对中位生存时间没有显著影响。没有猫需要针对PHA进行持续药物治疗。

结论及临床意义

尽管猫的PHA仍被认为是一种罕见疾病,但对于患有低钾性多肌病和全身性高血压的中老年猫应予以考虑。通过单侧肾上腺切除术进行手术矫正对于PHA的确定性治疗是一种可行的方法,无需持续药物管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85a6/4895543/eaec6e7e0403/JVIM-28-137-g001.jpg

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