目的:探討腎上腺嗜鉻細胞瘤的診治方法。方法:回顧性分析我院1995年10月～2008年10月收治37例腎上腺嗜鉻細胞瘤的臨床資料,總結其主要臨床表現、手術方法及圍手術期血壓的控制方法。結果:37例患者均行手術治療,其中35例術后血壓恢復正常,2例術后血壓未降至正常水平。結論:腎上腺嗜鉻細胞瘤的診斷主要依靠多種內分泌激素的測定及B超、CT的定位檢查,確診依賴于病理檢查,手術切除是有效的治療方法。術前的降壓、擴容和術后的補液升壓等圍手術期的處理是手術治療成功的關鍵。
According to the evidence pyramid model, systematic review (SR)/meta-analysis (MA) is one of the essential sources with a high level of clinical evidence. A high-quality SR/MA can effectively guide clinical decision-making and practice. The preferred reporting items for systematic reviews and meta-analyses extension for Chinese herbal medicines (PRISMA-CHM) were officially published in 2020. In this study, based on research cases, the features of PRISMA-CHM were interpreted in detail, so as to help domestic users accurately grasp the details of the reports, in order to improve the quality of the reports of SR/MA of traditional Chinese medicine.
Objective To discuss the application of dual-source computed tomography （CT） low dose technology in the upper abdomen enhanced inspection. Methods?Six hundred consecutive patients from July 2011 to February 2012 in this hospital were orderly divided into ordinal tube current （210?mAs） group and low dose tube current group （200 mAs，190?mAs，180?mAs，170?mAs，and 165?mAs）. The standard deviation （SD） of subcutaneous fat，signal to noise ratio （SNR） of liver and pancreas， contrast to noise ratio （CNR） of liver-erector spinae and pancreas-erector spinae，score of subjective diagnosis and the indexes of radiation dose，including CT dose index （CTDI），dose length product （DLP），effective dose （ED） were measured，calculated，and assessed respectively on CT images of arterial phase and portal phase from each group. Results?The SD of subcutaneous fat， SNRs of liver and pancreas，score of subjective diagnosis，and the CTDI，DLP，ED of CT images in arterial phase and portal phase were significantly different from each other （P＜0.05），while CNRs of liver-erector spinae and pancreas-erector spinae were not statistically significant （P＞0.05）. The SNR，radiation dose，and score of subjective diagnosis of the 165 mAs tube current group were the lowest among all the groups，but the images of the 165 mAs tube current group could not fulfill the need of diagnosis. Conclusions?It is really feasible that the method of decreasing tube current gradually in the upper abdomen enhanced CT inspection could ensure that the radiologists could adapt the low dose image bit by bit，and this methods could be popularized to all kinds of CT facilities we own currently. The images with 170?mAs as tube current in the upper abdomen enhanced inspection of dual-source CT could fulfill the need of diagnosis，and the radiation dose of patients is apparently lower than that the conventional scan．