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目的探讨嗜铬细胞瘤的临床特征,提高该病的诊治水平,以减少误诊。方法对我院收治并误诊的29例嗜铬细胞瘤的临床资料进行回顾性分析。结果本组误诊为原发性高血压病9例,冠心病(心律失常或心力衰竭)8例,消化系疾病6例,植物神经功能紊乱、泌尿系疾病各2例,脑供血不足、糖尿病各1例。结合临床表现、医技检查和术中所见证实均为嗜铬细胞瘤,其中肾上腺嗜铬细胞瘤20例(恶性2例),腹腔副神经节瘤4例(恶性1例),肾上腺增生、膀胱嗜铬细胞瘤各2例,病灶部位不明嗜铬细胞瘤1例。本组行手术治疗24例,术后均痊愈;3例恶性肿瘤确诊后3个月内死亡;1例病灶部位不明,予α受体阻滞剂药物治疗效果尚可;1例放弃治疗,出院后死亡。结论嗜铬细胞瘤临床表现复杂多样,易误诊,临床医生应掌握其发病机制和多种临床表现,及时行相关医技检查,避免或减少误漏诊。
Objective To investigate the clinical features of pheochromocytoma and to improve the diagnosis and treatment of the disease so as to reduce misdiagnosis. Methods The clinical data of 29 cases of pheochromocytoma admitted to our hospital and misdiagnosed were analyzed retrospectively. Results This group was misdiagnosed as essential hypertension in 9 cases, coronary heart disease (arrhythmia or heart failure) in 8 cases, digestive diseases in 6 cases, autonomic dysfunction, urological diseases in 2 cases, cerebral insufficiency, diabetes 1 case. Combined with clinical manifestations, medical examination and intraoperative findings are pheochromocytoma, including 20 cases of adrenal pheochromocytoma (malignant in 2 cases), abdominal paraganglioma in 4 cases (1 case of malignant), adrenal hyperplasia, Bladder pheochromocytoma in 2 cases, the location of unknown pheochromocytoma in 1 case. The group of surgical treatment of 24 cases were cured after surgery; 3 cases of malignant tumor died within 3 months after diagnosis; 1 case of unknown location, to α-blockers drug treatment effect was acceptable; 1 case of abandonment of treatment, discharged After the death. Conclusion The clinical manifestations of pheochromocytoma are complex and diverse, and are easily misdiagnosed. Clinicians should master the pathogenesis and various clinical manifestations of pheochromocytoma, and timely conduct relevant medical tests to avoid or reduce misdiagnosis.