Gifford R W, Manger W M, Bravo E L
Department of Nephrology and Hypertension, Cleveland Clinic Foundation, Ohio.
Endocrinol Metab Clin North Am. 1994 Jun;23(2):387-404.
None of the endocrine causes for hypertension is more fascinating and challenging for the clinician than pheochromocytoma. Its protean manifestations can make diagnosis difficult, yet its sinister prognostic implications demand prompt recognition and expert management. Diagnosis depends on clinical suspicion, demonstration of high levels of free catecholamines in the plasma or urine, or high localization of the tumor by appropriate imaging techniques that include CT scanning, MR imaging, and 131I-MIBG scintigraphy. Surgical extirpation is the treatment of choice unless the risk of operation is overwhelming or distant metastasis has already occurred. Successful outcome demands a team approach, taking advantage of the experience, skill, and expertise of the surgeon, anesthesiologist, and internist.
对于临床医生而言，没有哪种高血压的内分泌病因比嗜铬细胞瘤更具吸引力和挑战性。其多种多样的表现可能使诊断变得困难，但其凶险的预后影响需要迅速识别并进行专业处理。诊断依赖于临床怀疑、血浆或尿液中游离儿茶酚胺水平升高的证明，或通过包括CT扫描、磁共振成像和131I-间碘苄胍闪烁显像在内的适当成像技术对肿瘤进行精确定位。除非手术风险极大或已经发生远处转移，手术切除是首选治疗方法。成功的治疗需要团队协作，充分利用外科医生、麻醉师和内科医生的经验、技能和专业知识。
