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目的探讨皮质醇增多症患者肾上腺切除术后激素替代分析及护理。方法分析了2000-01-2008-06共有74例皮质醇增多症患者肾上腺切除术后激素替代的方法和效果。结果 4例(5.4%)患者术后出现急性肾上腺皮质功能减退,8例在激素减量过程中出现肾上腺皮质功能减退症状,其中2例血浆皮质醇水平处于正常范围。结论术前血清皮质醇水平较高者术后发生急性肾上腺皮质功能减退的风险可能增加,在激素减量过程中即使是血浆皮质醇水平处于正常范围者也可能出现肾上腺皮质功能减退症状。因此对皮质醇增多症患者肾上腺切除术后激素替代的患者应加强病情观察的护理及服药指导。
Objective To investigate the hormone replacement and nursing care of adrenalectomy patients with cortisol hypersecretion. Methods The method and effect of hormone replacement after adrenalectomy in 74 patients with CIN from 2000-01 to 2008-06 were analyzed. Results In 4 patients (5.4%), acute adrenocortical hypofunction was found in 8 patients, and adrenocortical hypofunction was observed in 8 patients during hormone deprivation. Two patients had normal plasma cortisol level. Conclusions The higher preoperative serum cortisol level may increase the risk of postoperative acute adrenocortical hypofunction. Adrenocortical hypofunction may occur even during the process of steroidogenesis, even if the plasma cortisol level is in the normal range. Therefore, patients with corticosteroid hyperandrogenism after adrenalectomy patients should strengthen the observation of the condition of care and medication guidance.