Koshida K, Nishikawa T, Ishida T, Naito K, Hisazumi H
Department of Urology, School of Medicine, Kanazawa University.
Hinyokika Kiyo. 1988 Apr;34(4):592-7.
A study of 30 cases of pheochromocytoma encountered at our department between 1959 and 1986 is presented. Fourteen patients were males and 16 were females. Their ages ranged from 18 to 72 years with a peak incidence in the fifties. Hypertension was present in 87% of the patients. The incidence of extra-adrenal tumors was 30% and that of malignancy 7%. The 24-hr urinary level of catecholamine was to a certain degree in accord with the location of the tumor and type of hypertension. Computed tomography and venous sampling were very useful for the diagnosis which had an accuracy rate of 100% in this series. Preoperative management using an alpha-blocker was effective in controlling blood pressure and circulating blood volume in most cases. Postoperative blood pressure was normalized within a week after operation in 85% of the patients who had been suffering from hypertension, although elevated levels of norepinephrine in urine were still noted in 56% of the patients one week after operation. Of the 27 follow-up cases, 21 cases (78%) were in good health and 2 cases were alive with hypertension with a mean follow-up period of 8.1 years. Four patients died, one during angiography, one of pulmonary edema one day after operation and the other 2 of metastases of malignant pheochromocytoma.
本文报告了1959年至1986年在我科收治的30例嗜铬细胞瘤患者的情况。其中男性14例,女性16例。年龄范围为18至72岁,发病高峰在五十岁。87%的患者有高血压。肾上腺外肿瘤的发生率为30%,恶性肿瘤的发生率为7%。24小时尿儿茶酚胺水平在一定程度上与肿瘤位置和高血压类型相符。计算机断层扫描和静脉采血对诊断非常有用,本系列病例的诊断准确率为100%。在大多数情况下,术前使用α受体阻滞剂进行管理可有效控制血压和循环血容量。85%术前患有高血压的患者术后一周内血压恢复正常,尽管术后一周仍有56%的患者尿去甲肾上腺素水平升高。在27例随访病例中,21例(78%)健康状况良好,2例患有高血压但存活,平均随访期为8.1年。4例患者死亡,1例死于血管造影,1例术后一天死于肺水肿,另外2例死于恶性嗜铬细胞瘤转移。