巨大良性肾上腺肿瘤手术治疗的临床分析(1)
【摘要】 目的：比较分析腹腔镜手术及开放手术治疗良性的肾上腺巨大肿瘤(直径>6 cm)的效果。方法：回顾性分析手术治疗34例巨大良性肾上腺肿瘤患者的资料，分为A组、B组，A组18例接受开放手术，B组16例接受腹腔镜手术，比较两组患者的手术时间、术中失血量、手术次日切口疼痛评分、术后住院时间等。结果：两组均顺利完成手术，A组平均手术时间少于B组；A组术后切口疼痛数字评分大于B组；A组出血量及术后住院天数均多于B组，以上差异均有统计学意义(P<0.05)。结论：治疗巨大肾上腺良性肿瘤，开放手术用时更短，而腹腔镜手术创伤更小、恢复较快、患者痛苦少。术者技术熟练时，腹腔镜手术治疗肾上腺巨大良性肿瘤更安全、有效。
【关键词】 肾上腺巨大肿瘤； 肾上腺肿瘤切除术； 开放手术； 腹腔镜手术
中图分类号 R699.3 文献标识码 B 文章编号 1674-6805(2016)21-0109-02
【Abstract】 Objective：To compare and analyze the efficacy of laparoscopic surgery and open surgery in treatment of benign adrenal tumors(diameter>
, 百拇医药
6 cm).Method：The data of 34 patients with large adrenal neoplasms who underwent surgical treatment were retrospectively analyzed.They were divided into group A，group B，group A had 18 patients，they were treated with open surgery，group B had 16 patients，they were treated with laparoscopic operation.The operation time，bleeding loss，visual analogue scale of the first day after operation and hospital stay and so on were compared between the two groups.Result：Two groups were successfully completed surgery，the average operation time in group A was shorter than that in group B，the postoperative incision pain score in group A was higher than that in group B，the bleeding loss and postoperative hospital stay were both greater than those in group B，the differences above were all statistically significant(P<0.05).Conclusion：In treating large benign adrenal neoplasms，open surgery needs less time，while laparoscopic surgery causes less trauma，fastly recovery，patient’s pain is less.When the operator has skilled technology，laparoscopic operation is a feasible and safety for treating large benign adrenal neoplasms.
, 百拇医药
【Key words】 Adrenal neoplasms； Adrenalectomy； Open surgery； Laparoscopy
First-author’s address：Wendeng Central Hospital of Weihai，Weihai 264400，China
doi：10.14033/j.cnki.cfmr.2016.21.059
随着腹腔镜手术技术的日益成熟，对于治疗良性肾上腺肿瘤，腹腔镜肾上腺肿瘤切除术已经逐渐替代了绝大部分开放手术。然而在切除体积较大的肾上腺肿瘤时，腹腔镜手术术者缺乏对组织的质地、立体结构的直观感受，在一定程度上限制了腹腔镜手术在巨大的肾上腺良性肿瘤切除术中的应用。现回顾性分析2006年1月-2015年1月住院的34例肾上腺巨大肿瘤患者，分别接受开放手术或腹腔镜手术治疗，对两组患者治疗数据进行比较并报道如下。
, http://www.100md.com
1 资料与方法
1.1 一般资料
选取2006年1月-2015年1月住院的34例肾上腺巨大肿瘤(直径>6 cm)患者，34例患者分为A组(开放手术组)和B组(腹腔镜手术组)，其中A组共18例，男6例，女12例，左侧8例，右侧10例，肿瘤直径(8.0±2.6)cm；B组共16例，男7例，女9例，左侧11例，右侧5例，肿瘤直径(7.4±1.4)cm。两组患者肿瘤直径等一般资料比较差异无统计学意义(P>0.05)，具有可比性。
1.2 手术方法
术前均行增强CT或MRI检查，完善术前常规化验、检查，行24 h尿皮质醇、24 h尿香草扁桃酸及卧立位血醛固酮、肾素化验，术前诊断怀疑皮质醇增多症的患者术中备用氢化可的松，怀疑醛固酮增多症的患者术前给予补钾利尿及降压治疗，考虑嗜铬细胞瘤的患者术前给予控制血压、扩容。, 百拇医药(邢绍强 董礼明 孙长海)
【关键词】 肾上腺巨大肿瘤； 肾上腺肿瘤切除术； 开放手术； 腹腔镜手术
中图分类号 R699.3 文献标识码 B 文章编号 1674-6805(2016)21-0109-02
【Abstract】 Objective：To compare and analyze the efficacy of laparoscopic surgery and open surgery in treatment of benign adrenal tumors(diameter>
, 百拇医药
6 cm).Method：The data of 34 patients with large adrenal neoplasms who underwent surgical treatment were retrospectively analyzed.They were divided into group A，group B，group A had 18 patients，they were treated with open surgery，group B had 16 patients，they were treated with laparoscopic operation.The operation time，bleeding loss，visual analogue scale of the first day after operation and hospital stay and so on were compared between the two groups.Result：Two groups were successfully completed surgery，the average operation time in group A was shorter than that in group B，the postoperative incision pain score in group A was higher than that in group B，the bleeding loss and postoperative hospital stay were both greater than those in group B，the differences above were all statistically significant(P<0.05).Conclusion：In treating large benign adrenal neoplasms，open surgery needs less time，while laparoscopic surgery causes less trauma，fastly recovery，patient’s pain is less.When the operator has skilled technology，laparoscopic operation is a feasible and safety for treating large benign adrenal neoplasms.
, 百拇医药
【Key words】 Adrenal neoplasms； Adrenalectomy； Open surgery； Laparoscopy
First-author’s address：Wendeng Central Hospital of Weihai，Weihai 264400，China
doi：10.14033/j.cnki.cfmr.2016.21.059
随着腹腔镜手术技术的日益成熟，对于治疗良性肾上腺肿瘤，腹腔镜肾上腺肿瘤切除术已经逐渐替代了绝大部分开放手术。然而在切除体积较大的肾上腺肿瘤时，腹腔镜手术术者缺乏对组织的质地、立体结构的直观感受，在一定程度上限制了腹腔镜手术在巨大的肾上腺良性肿瘤切除术中的应用。现回顾性分析2006年1月-2015年1月住院的34例肾上腺巨大肿瘤患者，分别接受开放手术或腹腔镜手术治疗，对两组患者治疗数据进行比较并报道如下。
, http://www.100md.com
1 资料与方法
1.1 一般资料
选取2006年1月-2015年1月住院的34例肾上腺巨大肿瘤(直径>6 cm)患者，34例患者分为A组(开放手术组)和B组(腹腔镜手术组)，其中A组共18例，男6例，女12例，左侧8例，右侧10例，肿瘤直径(8.0±2.6)cm；B组共16例，男7例，女9例，左侧11例，右侧5例，肿瘤直径(7.4±1.4)cm。两组患者肿瘤直径等一般资料比较差异无统计学意义(P>0.05)，具有可比性。
1.2 手术方法
术前均行增强CT或MRI检查，完善术前常规化验、检查，行24 h尿皮质醇、24 h尿香草扁桃酸及卧立位血醛固酮、肾素化验，术前诊断怀疑皮质醇增多症的患者术中备用氢化可的松，怀疑醛固酮增多症的患者术前给予补钾利尿及降压治疗，考虑嗜铬细胞瘤的患者术前给予控制血压、扩容。, 百拇医药(邢绍强 董礼明 孙长海)