目的:探讨肾上腺嗜铬细胞瘤的诊治方法。方法:回顾性分析我院1995年10月~2008年10月收治37例肾上腺嗜铬细胞瘤的临床资料,总结其主要临床表现、手术方法及围手术期血压的控制方法。结果:37例患者均行手术治疗,其中35例术后血压恢复正常,2例术后血压未降至正常水平。结论:肾上腺嗜铬细胞瘤的诊断主要依靠多种内分泌激素的测定及B超、CT的定位检查,确诊依赖于病理检查,手术切除是有效的治疗方法。术前的降压、扩容和术后的补液升压等围手术期的处理是手术治疗成功的关键。
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.
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.