嗜铬细胞

Data and method 1.1 average data this group 16 patients, the male 6, female 10, age 32~62 year old, association of anaesthetic doctor of AS classification class of Ⅱ~Ⅲ, tumor is located in adrenal 15, hind peritoneal 1. There is clonic or durative blood pressure to lift before 14 art, 2 do not have afore-mentioned symptoms. The pathology after all case method is checked all diagnose is tumour of chromic cell of be addicted to.

手术和麻醉的风险较大，我院2000年~2007年对16例嗜铬细胞瘤患者实施肿瘤切除手术，现将麻醉处理报告如下。1资料和方法1.1一般资料本组16例患者，男性6例，女性10例，年龄32~62岁，AS分级Ⅱ~Ⅲ级，肿瘤位于肾上腺15例，后腹膜1例。14例术前有阵发性或持续性血压升高，2例无上述症状。

Prepare before 1.2 anaesthesia and а is taken to suffer body block to break phenolic benzyl of medical hydrochloric acid after the person that with medicine every has clonic or durative blood pressure to lift before art is admitted to hospital bright, every time 10~20mg, everyday 2~3 second, successive 2~4 week, partial patient complementary with Katuopuli.

所有病例术后病理学检查均确诊为嗜铬细胞瘤。1.2麻醉前预备和术前用药凡有阵发性或持续性血压升高者入院后服用а受体阻断药盐酸酚苄明，每次10~20mg，天天2~3次，连续2~4周，部分患者辅以卡托普利。

Urine VMA level is a useful marker to detect extra-adrenal pheochromocytoma and CT scan is the most reliable in localizing the lesions.131-MIBG scintigraphy is of great value for the localiza-tion and quantitative for extrarenal pheochromocytoma with high sensitivity and accuracy.It may be also used as a therapeutic method.

VMA及血、尿儿茶酚胺是定性诊断异位嗜铬细胞瘤的主要依据，CT诊断定位准确、131碘-间位碘代苄胍(131I-MIBG)定位准确、敏感性高，且可作为治疗措施。

The attenuation values at unenhanced and enhanced CT of the tumor were also recorded. Results The 32 cases adrenal neoplasms included 9 cases with aldosterone-producing adenoma, 5 hydrocortisone-producing adenomas, 1non-functional adenoma, 5 cortical hyperplasies,4 pheochromocytomas,2 adenocarcinomas, 3 metastases, 1 fibroneuroma, 1 ganglioneuroma and 1 myelolipomas. Conclusion The characteristics on CT images are associated with the pathological feature in adrenal neoplasms.

结果 醛固酮腺瘤9例，体积较小且密度低，增强后轻度增强；皮质醇腺瘤5例，瘤体较大，边界清，密度略低于正常肾上腺组织；无功腺瘤1例；结节增生5例，为等或稍低密度影，增强后强化较明显；嗜铬细胞瘤4例，体积较大，密度不均，可见多个囊变坏死区；皮质腺癌2例，肿块形态不规则，边缘模糊，密度不均匀，易发生大片坏死及点状钙化；转移瘤3例；神经纤维瘤、神经节瘤及髓性脂肪瘤各1例。

MEN1 is characterized by parathyroid adenoma, gastroenteropancreatic and anterior pituitary tumors. MEN2A and MEN2B are characterized by medullar thyroid carcinoma, pheochromocytoma, parathyroid hyperplasia and mucosa neurofibroma, respectively.

多内分泌腺瘤病2型(MEN2)主要由原癌基因RET突变所致，又分为MEN2A和MEN2B，临床表现为甲状腺髓样癌、嗜铬细胞瘤、甲状旁腺增生和黏膜神经纤维瘤。

Results: All four cases were misdiagnosed as gastric ulcer, hepatic abscess, hepatic tumor, or pancreatic tumor, and three of them underwent operation detection for alimentary tract neoplasma, but the final histopathologic examlnations showed pheochromocytomas in all the cases.

结果：4例患者分别被误诊为&胃溃疡&、&肝脓肿&、&肝肿瘤&、&胰腺肿瘤&等，3例以消化道肿瘤行手术探查，而后病检均为嗜铬细胞瘤。

BACKGROUND: Prolonged gastric acid suppression leads to hypergastrinaemia, which promotes hyperplasia of the enterochromaffin-like cells of the oxyntic mucosa.

长期的胃酸抑制可导致高胃泌素血症，可促进泌酸粘膜的肠样嗜铬细胞增生。

No pneumothorax or viscera injury was complicated.both the transperitoneal and retroperitoneal laparoscopic approaches are feasible and safe for pheochromocytoma with the advantages of minimal invasion.

两种不同的入路施行腹腔镜肾上腺嗜铬细胞瘤切除术都是安全可行，具有操作精细、创伤小、恢复快等优点。

Objective To improve the diagnosis of coexisting pheochromocytoma and renal artery stenosis.

目的 提高对嗜铬细胞瘤合并肾动脉狭窄的诊断与治疗水平。

Understand the carcinomatous metastasis of thyroid cancer curring by 131I , Polycythemia Vera curring by 32P, malignant pheochromocytoma curring by 131I—MIBG ,the indication and contraindication of β-therapy.

32P治疗真性红细胞增多症、胶体Cr32PO4腔内治疗131I—MIBG治疗恶性嗜铬细胞瘤以及β射线敷贴治疗的适应症和禁忌症。

Do you know, i need you to come back

你知道吗，我需要你回来

Yang yinshu、Wang xiangsheng、Li decang,The first discovery of haemaphysalis conicinna.

1〕 杨银书，王祥生，李德昌。安徽省首次发现嗜群血蜱。