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嗜铬细胞瘤引起的高血压顽固而难以控制,一般降压药难以奏效.笔者用琉甲丙脯酸治疗二例效果较好特报告如下:例1:男12岁,因头痛20余天,阵发性视物不清,抽搐三次入院.查体:T 37℃,P 120次/分,R 22次/分,BP 24/18KPa,面部多汗,心界向左下扩大,心尖区第一心音亢进,肝右肋下2cm质韧.心电图示:左心室肥大心肌劳累.腹部B超:腹膜后探及3.2×2.9cm实质性包块,CT检查:双肾上腺均增大呈类圆形结节影,右侧约2.5×2.5cm,左侧约3×3cm,,实验室检查:VMA(香草基杏仁酸)85.3_μmol/24h尿(正常值5~40.3_μmol/24h尿),CA(儿茶酚胺)695n mol/24h尿(正常值0~650n mol/24h尿),诊断嗜铬细胞瘤.治疗:除入院第一天给予α受体阻滞剂一次,以后均口服巯甲丙脯酸1mg/(kg.次),每日三次维持控制全身症状,当血压有阵发性增高时可加服一次(剂量同上),血压均在半小时后降至正常范围,经治疗五天后血压稳定,一周后转外科手术切除肿瘤,经病理证实为嗜铬细胞瘤.
Hypertensive hypertension caused by pheochromocytoma is stubborn and difficult to control, the general antihypertensive drugs are difficult to work. The author reported that the efficacy of two cases of treatment with captopril was better reported as follows: Example 1: Male 12 years old, due to headache for more than 20 days, array Obstructive vision was unclear, convulsions were admitted to the hospital three times. Physical examination: T 37°C, P 120 beats/min, R 22 beats/min, BP 24/18KPa, hyperhidrosis on the face, heart border expanding to the lower left, first apex Sound hyperthyroidism, liver right under the ribs 2cm quality and toughness. ECG icon: left ventricular hypertrophy myocardial fatigue. Abdominal B: retroperitoneal exploration and 3.2 × 2.9cm substantial mass, CT examination: both adrenal glands are increased like a round knot The section is about 2.5 x 2.5cm on the right side and about 3 x 3cm on the left side. Laboratory examination: VMA (vanilla-based mandelic acid) 85.3_μmol/24h urine (normal value 5~40.3_μmol/24h urine), CA (catecholamine) ) 695n mol/24h urine (normal value 0-650n mol/24h urine) for the diagnosis of pheochromocytoma. Treatment: Alpha-blocker was given on the first day of admission, followed by oral captopril 1mg/ (Kg. times), to maintain control of the systemic symptoms three times a day, when the blood pressure has increased paroxysmal can be added once (dose ibid.), blood pressure fell to normal range after half an hour, stable blood pressure after five days of treatment, a week After the transfer of surgical hand Tumors were excised, pathologically confirmed pheochromocytoma.