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目的:总结副神经节瘤的临床特点、诊断及治疗方法,提高副神经节瘤的临床认识和诊治水平。方法:回顾性分析中国人民解放军第309医院2010~2014年间经病理证实的肾上腺外副神经节瘤病例11例临床资料,分析其术前检查、诊断、术前准备与术中意外发生情况,并结合国内外文献总结其诊治要点。结果:11例副神经节瘤患者中除2例明确肺部转移患者行保守治疗外,其余9例患者均接受手术治疗。其中2例术前考虑副神经节瘤,围手术期按照诊疗规范进行周密准备,手术安全、顺利完成;7例患者术前未考虑副神经节瘤或者围手术期未按照诊疗规范准备,术中分别发生了局麻改全麻、腔镜转开放、大量出血、术中输血、血压剧烈波动而手术终止等意外情况。结论:术前明确诊断,充分准备,术中严密麻醉监护,精细手术操作是副神经瘤手术安全成功的关键。血管外科的手术技巧对于术中处理血管损伤非常关键。
Objective: To summarize the clinical features, diagnosis and treatment of paraganglioma and to improve the clinical knowledge and diagnosis and treatment of paraganglioma. Methods: A retrospective analysis of 11 cases of pathologically confirmed adrenal paraganglioma cases from 309th Hospital of Chinese People’s Liberation Army from 2010 to 2014 was performed to analyze the preoperative examination, diagnosis, preoperative preparation and accidental surgery. Combined with domestic and foreign literature summarizes the main points of diagnosis and treatment. Results: Of the 11 patients with paragangliomas, 2 patients were treated with conservative treatment of lung metastases, and the remaining 9 patients were treated surgically. Paraganglioma was preoperatively considered in 2 of them. Perioperative preparation was performed in accordance with the standard of diagnosis and treatment. The operation was safe and successfully completed. Seven patients had no preoperative paraganglioma or were not perioperatively prepared according to the diagnostic criteria. Respectively, the local anesthesia general anesthesia, endoscopic turn to open, a large number of bleeding, intraoperative blood transfusion, severe fluctuations in blood pressure and the termination of surgery and other accidents. Conclusion: Preoperative definite diagnosis, adequate preparation, intraoperative anesthesia intensive care, fine surgical operation is the key to the success of surgical treatment of neuroma. Vascular surgical techniques are critical to intravascular vascular injury.