腹腔镜手术治疗妊娠合并肾上腺源性库欣综合征1例并文献复习
A Case of Laparoscopic Surgery in the Treatment of Pregnancy with Cushing Syndrome Caused by Adrenal Adenoma and Literature Review
DOI: 10.12677/ACM.2022.124491, PDF,   
作者: 王琨翔, 杨学成：青岛大学附属医院泌尿外科，山东 青岛；孙瑞霞：青岛大学附属医院内分泌科，山东 青岛；陈 颖：青岛大学附属医院代谢性疾病科，山东 青岛；彭 伟, 纪玉芝：青岛大学附属医院产科，山东 青岛
关键词: 妊娠肾上腺腺瘤；库欣综合征；腹腔镜手术；Adrenal Adenomas of Pregnancy； Cushing’s Syndrome； Laparoscopic Surgery
摘要: 目的：报道一例腹腔镜手术治疗妊娠期合并肾上腺源性库欣综合征，探讨腹腔镜手术治疗妊娠期合并肾上腺源性库欣综合征的可行性与有效性。方法：报道一例病例并回顾分析国内外妊娠合并肾上腺源性库欣综合征的相关文献。共检索到38例在妊娠期进行肾上腺切除术治疗肾上腺腺瘤引起的库欣综合征。结果：库欣综合征对母亲及胎儿的生命造成严重威胁，而妊娠使其诊断与治疗复杂化。孕中期经腹膜后腹腔镜手术是治疗肾上腺源性的库欣综合征的合理有效的方法，可降低胎儿围产期死亡率和母体妊娠相关并发症的发病率，但不能避免胎儿早产和宫内生长受限的发生。结论：妊娠合并库欣综合征诊断治疗相对复杂，应由泌尿外科、内分泌科、妇产科等多学科协同诊治。孕中期腹腔镜下肾上腺腺瘤切除术是治疗妊娠合并肾上腺源性库欣综合征的合理有效的方法。
Abstract: Objective: To report a case of laparoscopic surgery in the treatment of Cushing’s syndrome (CS) caused by adrenal adenoma during pregnancy, the feasibility and effectiveness of laparoscopic surgery in the treatment of CS caused by adrenal adenoma during pregnancy were discussed. Methods: We report a case. Then, we review and analyze the domestic and foreign literature on pregnancy complicated with adrenal CS. We retrieved 38 cases of CS caused by adrenal adenoma treated with adrenalectomy during pregnancy. Results: CS poses a serious threat to the lives of mothers and fetuses, and pregnancy complicates the diagnosis and treatment. Laparoscopic adrenal adenoma resection in the second trimester is a reasonable and effective method for the treatment of pregnancy complicated with adrenal CS. It can reduce the fetal perinatal mortality and the incidence of maternal pregnancy-related complications, but it cannot avoid the occurrence of premature fetal delivery and intrauterine growth restriction. Conclusions: The diagnosis and treatment of pregnancy complicated with CS is relatively complicated, and the diagnosis and treatment should be coordinated by a multidisciplinary team, consisting of urologists, obstetricians, endocrinologists. Laparoscopic adrenal adenoma resection in the second trimester is a reasonable and effective method for the treatment of pregnancy complicated with CS caused by adrenal adenoma.
文章引用：王琨翔, 孙瑞霞, 陈颖, 杨学成, 彭伟, 纪玉芝. 腹腔镜手术治疗妊娠合并肾上腺源性库欣综合征1例并文献复习[J]. 临床医学进展, 2022, 12(4): 3393-3403. https://doi.org/10.12677/ACM.2022.124491

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