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目的:探索皮质醇增多症围手术期激素替代治疗的临床疗效,以期为临床实践提供参考。方法:选取我院于2014年6月至2015年6月间收治的30例术前确诊为皮质醇增多症患者作为研究对象。对30例患者围手术期内采用简化激素替代方案治疗,观察记录术后患者临床症状,并对患者血皮质醇、尿皮质醇进行不定时检测,以此评价激素替代治疗的临床效果。结果:经统计发现,围手术期术后第1、2d患者尿皮质醇较术前增加,术后第6尿皮质回落平,但较术前尿皮质变化,无显著性差异(P>0.05),第7d回落显著(P<0.05);血皮质醇术后第1d相较于术前有所回落(P>0.05),术后第2、6、7d变化显著(P<0.05),具有统计学意义。此外,无一例患者出现围手术期肾上腺皮质功能不全临床症状,患者血压、心率以及电解质术前术后变化不显著(P>0.05)。结论:皮质醇增多症围手术期激素替代治疗方案相对简单,安全可靠,有助于改善患者病情,是一种具有较强实用价值的治疗方案。
Objective: To explore the clinical effect of perioperative hormone replacement therapy for Cushing ’s disease in order to provide reference for clinical practice. Methods: Thirty patients with preoperative diagnosis of CIN in our hospital from June 2014 to June 2015 were selected as the study subjects. Thirty patients were treated with simplified hormone replacement therapy during the perioperative period. The clinical symptoms of the patients were observed and recorded. The clinical effects of hormone replacement therapy were evaluated in patients with cortisol and urinary cortisol irregularly. Results: According to the statistics, urinary cortisol increased in the first and second day after operation, and the sixth urinary cortex returned to the normal level after operation, but there was no significant difference (P> 0.05) (P <0.05). The level of blood cortisol decreased on the 1st day after operation compared with that before operation (P> 0.05), and on the 2nd, Significance of learning. In addition, none of the patients showed clinical symptoms of perioperative adrenal insufficiency. The patients’ blood pressure, heart rate and preoperative and postoperative electrolyte changes were not significant (P> 0.05). Conclusion: Perioperative corticosteroid replacement therapy is relatively simple, safe and reliable, and helps to improve the patient’s condition. It is a kind of treatment plan with strong practical value.