【摘要】 本文结合111例皮质醇增多症的临床分析,根据其不同病理类型,对治疗方案的选择进行了讨论。增生型无明确垂体瘸者主张肾上腺次全切除加垂体放疗;有明显垂体瘤者,不论有无压迫症状均主张先行垂体手术,3～6月后皮质醇增多症症状未缓解者,再行肾上腺次全切除术。肾上腺腺瘤手术疗效满意。腺癌应手术根治,晚期不能手术者可用二氯苯二氯乙烷治疗。异位ACTH综合征根治原发病灶后皮质醇增多症可期缓解。更多还原

【Abstract】 111 cases of Cushing’s syndrome were analysed in which 101 cases were pathologically proved and 10 were clinically diagnosed. The choice of treatment according to the different pathological types was discussed. In cases of bilateral hyperplastic type without evidence of pituitary tumor (52 cases), bilateral subtotal adrenalectomy followed by pituitary irradiation was preferred. In cases of hyperplastic type with apparent evidence of pituitary tumor (11 cases including one case of Nelson’s syndrome), operation on pituitary gland should be performed first irrespective of absence of compression syndrome and 3-6 months later followed by subtotal adrenolectomy if necessary, o,p’-DDD and adrenal blockers were used in some of these patients or just pre-operatively. In cases of adrenal cortical adenoma (29 cases), simple unilateral adrenolectomy would produce satisfactory results. Adenocarcinomas of adrenal cortex (8 cases) should receive radical operation while in late inoperable cases, o,p’-DDD was the drug of choice. In one case of ectopic ACTH syndrome, hypercortisolism remitted after an effective treatment of the primary lesion.更多还原