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目的探讨单侧肾上腺结节样增生CT检查的准确性及手术治疗的可行性。方法回顾性分析经手术病理证实的9例单侧肾上腺结节样增生的临床和CT资料,统计术前CT的误诊率,并随访其术后症状控制、血压以及血钾改善情况。结果共收集醛固酮腺瘤患者168例,其中术后病理证实为结节样增生的患者9例,以肾上腺CT醛固酮腺瘤最大直径分组,<10mm组CT误诊率为33.33%,≥10mm组为4.32%。8例单侧肾上腺结节样增生患者术后乏力、手麻、手足搐愵等症状消失;6例术后血压恢复正常,2例术后血压好转;7例血钾恢复正常,1例低钾较前好转。结论 (1)肾上腺CT检查的特异性低,误诊率高,尤其是对于小于10mm的病灶。(2)单侧肾上腺结节样增生手术治疗效果好,可以达到根治的目的。
Objective To investigate the accuracy and feasibility of surgical treatment of unilateral adrenal nodular hyperplasia (CT). Methods The clinical and CT data of 9 cases of unilateral adrenal nodular hyperplasia confirmed by surgery and pathology were retrospectively analyzed. The misdiagnosis rate of preoperative CT was calculated. The postoperative symptom control, blood pressure and serum potassium were also followed up. Results A total of 168 patients with aldosterone adenoma were collected. Among them, 9 cases were pathologically confirmed as nodular hyperplasia, with the largest diameter of adrenal CT aldosterone adenoma. The misdiagnosis rate was 33.33% in <10mm group and 4.32 in ≥10mm group %. Eight patients with unilateral adrenal nodular hyperplasia postoperative fatigue, hand numbness, tetany and other symptoms disappeared; 6 cases of postoperative blood pressure returned to normal, 2 cases of postoperative blood pressure improved; 7 cases of serum potassium returned to normal, 1 case of low potassium Better than before. Conclusion (1) Adrenal CT examination of low specificity, misdiagnosis rate, especially for lesions less than 10mm. (2) unilateral adrenal nodular hyperplasia surgery is effective, can achieve the purpose of radical.