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目的探讨多发性肾上腺醛固酮瘤的诊治方法。方法回顾性分析了我院自1992年10月至2006年4月18例多发性肾上腺醛固酮瘤的临床资料和诊治方法。结果一侧肾上腺同时多发性醛固酮瘤4例,三维 CT 检查发现同侧肾上腺3枚肿瘤,行患侧肾上腺及肿瘤切除术,同时双侧肾上腺多发性醛固酮瘤6例,行双肾上腺肿瘤切除术,异时多发性肾上腺醛固酮瘤8例,包括一侧肾上腺醛固酮瘤行肿瘤切除术后患侧复发2例,行探查和残留肾上腺及肿瘤切除术;一侧肾上腺醛固酮瘤行患侧肾上腺及肿瘤切除术后对侧肾上腺醛固酮瘤6例,行肿瘤切除术。术后复查,未见肿瘤复发,肾上腺功能测定正常。结论单侧多发性肾上腺醛固酮瘤应行肾上腺及肿瘤切除术;双侧或异时性多发性肾上腺醛固酮瘤宜行肿瘤切除术,术中尽量保留正常肾上腺组织。三维 CT 的诊断价值较高,可以应用于临床肿瘤直径较小的同时多发性醛固酮瘤以及异时同侧多发的醛固酮瘤。
Objective To investigate the diagnosis and treatment of multiple adrenal aldosteronoma. Methods A retrospective analysis of our hospital from October 1992 to April 2006 18 cases of multiple adrenal aldosteronoma clinical data and diagnosis and treatment methods. Results One side of adrenal at the same time multiple aldosteronoma in 4 cases, three-dimensional CT examination found ipsilateral adrenal gland three tumors, the ipsilateral adrenalectomy and tumor resection, while bilateral adrenal multiple aldosterone tumors in 6 cases, adrenal resection, Heterotopic multiple adrenal aldosteronoma in 8 cases, including one side of adrenal aldosterone tumor resection ipsilateral recurrence in 2 cases, exploration and residual adrenalectomy and tumor resection; adrenal aldosterone on one side of the adrenal gland tumor and tumor resection Late contralateral adrenal aldosteronoma in 6 cases, the tumor resection. Postoperative review, no tumor recurrence, normal adrenal function. Conclusions Unilateral multiple adrenal aldosteronoma should be treated with adrenalectomy and resection of the tumor. Bilateral or metachronous multiple adrenal aldosteronism should be treated by tumor resection. The normal adrenal tissue should be retained as far as possible. Three-dimensional CT diagnosis of high value, can be applied to clinical tumor diameter at the same time smaller aldosterone tumor and ileocecal multiple aldosterone tumor.