干旱区生态环境知识资源中心(Arid): 膀胱嗜铬细胞瘤的诊断与治疗

Arid

	膀胱嗜铬细胞瘤的诊断与治疗
其他题名	Diagnosis and treatment of pheochromocytoma in urinary bladder
	钱立新; 吴宏飞; 眭元庚; 张炜; 张立新; 殷长军; 顾民; 徐正铨; 尤国才
来源期刊	中华泌尿外科杂志
ISSN	1000-6702
出版年	2003
卷号	24 期号:9 页码:591-593
中文摘要	目的提高膀胱嗜铬细胞瘤的诊断和治疗水平。方法 7例膀胱嗜铬细胞瘤患者中高血压5例，其中4例在排尿时发作；间歇性肉眼血尿3例。5例B超检查发现膀胱肿瘤，6例膀胱镜检查见黏膜下肿瘤；2例尿VMA升高。术前确诊2例，口服alpha受体阻滞剂2周。7例均在硬膜外麻醉下进开放手术，6例行膀胱部分切除，1例行膀胱部分切除加输尿管膀胱再植术，术中血压波动2例。结果 6例经术后常规病理、1例经术中快速冰冻切片及免疫组织化学病理诊断为膀胱嗜铬细胞瘤。随访1～10年，1例术后2年转移，诊断为恶性嗜铬细胞瘤，其他6例血压正常，无肿瘤复发。结论血尿、高血压和排尿时典型发作三联征为膀胱嗜铬细胞瘤的主要症状，可应用B超、CT、MRI、~(131)I-MIBC作定位诊断，尿VMA和尿儿茶酚胺作定性诊断。手术切除是首选治疗方法，术后应密切随访。
英文摘要	Objective To evaluate the approaches for diagnosis and treatment of pheochromocytoma in urinary bladder. Methods Seven cases of bladder pheochromocytoma were included. Hypertension was observed in 5 cases, of whom 4 had paroxysmal hypertension during urination. Intermittent macrohematuria was found in 3 cases. Bladder occupations were detected by B-ultrasound in 5 cases and bladder submucosal neoplasms were discovered with cystoscopy in 6 cases. Urine VMA was elevated in 2 cases. Two cases were preoperatively suspected of having bladder pheochromocytoma and took ct-receptor blocker for 2 weeks. Par-tial cystectomy was performed in 6 cases,and partial cystectomy combined with ureterovesical anastomosis in 1. Results Of the 7 oases,6 were pathologically diagnosed as pheochromocytoma postoperatively,the oth-er one was diagnosed by frozen-section sample during operation. During the 1 to 10 years’ follow-up,one pa-tient suffered from metastatic tumor 2 years after initial operation and this case was confirmed as malignant pheochromocytoma. The other 6 cases had normal blood pressure and no recurrent tumor developed. Conclusions The typical compsite symptoms of bladder pheochromocytoma consist of intermittent macrohematu-ria ,hypertension and paroxysmal occurrence during micturition. B-ultrasound, CT.MRI and m I-MIBG scin-tigraphy have higher value in localizing the lesions. Urinary VMA and catecholamine detection is useful in qualitative diagnosis. Surgical excision of the tumor is the preferred management. Mesuring the level of urina-ry catecholamine can monitor the recurrence or metastasis of the tumor.
中文关键词	嗜铬细胞瘤 ; 膀胱 ; 诊断 ; 治疗学
英文关键词	pheochromocytoma bladder diagnosis therapeutics
语种	中文
国家	中国
收录类别	CSCD
WOS类目	SURGERY
WOS研究方向	Surgery
CSCD记录号	CSCD:1257970
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/204725
作者单位	南京医科大学第一附属医院泌尿外科, 210029
推荐引用方式 GB/T 7714	钱立新,吴宏飞,眭元庚,等. 膀胱嗜铬细胞瘤的诊断与治疗[J],2003,24(9):591-593.
APA	钱立新.,吴宏飞.,眭元庚.,张炜.,张立新.,...&尤国才.(2003).膀胱嗜铬细胞瘤的诊断与治疗.中华泌尿外科杂志,24(9),591-593.
MLA	钱立新,et al."膀胱嗜铬细胞瘤的诊断与治疗".中华泌尿外科杂志 24.9(2003):591-593.