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1、第16卷第1期中国现代医学杂志Vol.16No.12006年1月ChinaJournalofModernMedicineJan.2006文章编号:1005-8982(2006)01-0126-03嗜铬细胞瘤术前准备的临床分析程勇,洪梅,王晓隆(泸州医学院附属医院泌尿外科,四川泸州646000)摘要:目的探讨嗜铬细胞瘤术前准备的临床体会。方法收集2000~2004年收治58例嗜铬细胞瘤患者术前准备资料,术前使用酚苄明48例,使用压宁定10例,用药时间2~9周,平均6周,28%的患者术前加用β-受体阻滞剂控制心率。结果50例患者血压
2、稳定在135/85mmHg左右,无阵发性血压升高、心悸、多汗等现象,体重呈增加趋势,心率80~85次/min,外周微循环明显改善。肿瘤大小(直径3~12cm,平均5.2cm)与功能和用药时间长短无明显关系,术前2周发生高血压危象7例,97%的患者麻醉诱导和术中挤压肿瘤时血压仍发生波动,最高时可达280/180mmHg,但较易控制。术后血压平稳。结论嗜铬细胞瘤术前充分的准备是保证麻醉、术中及术后血压平稳控制,减少心血管并发症和死亡率的关键。关键词:嗜铬细胞瘤;α-肾上腺素阻滞剂;术前准备中图分类号:R736.6文献标识码:BCli
3、nicalanalysisofpreoperativepreparationforpheochromocytomaCHENGYong,HONGMei,WANGXiao-long(DepartmentofUrology,theAffiliatedHospitalofLuzhouMedicalCollege,Luzhou,Sichuan646000,P.R.China)Abstract:【Objective】Toinvestigatethepreoperativepreparationforpheochromocytoma.【Met
4、hods】Thedataof58casesofpheochromocytoma,whoweretreatedinourhospitalform2000to2004,werecollectedandreviewedaboutthepreoperativeprepatation.Phenoxybenzaminewasgivento48casesandurapidilto10duringpreoperativeperiod,lastingfor2~9weekswithameanof6weeks.In28%ofthecases,β-ad
5、renergicblockerwasgivenforcon-trolofheartrate.【Results】In50cases,bloodpressureremainedstableatthelevelof135/85mmHgorso.Noparoxysmalhypertension,palpitationandsweationoccurredafteruseofα-blockade.Theheartrateremained80~85times/min.Noarrhythmiaoccurred.Peri-microcirclu
6、ationwasobviouslyimproved.Thetumorsize(3~12cmindiam-eter;average5.2cm)wasnotrelatedtothefunctionandlengthofpreoperativeuseofthemedications.Hypertensivecrisisoccurredin7cases2weeksbeforeoperation.Inmostcases(97%),bloodpressurefluctuated(reachingupto280/180mmHg)whenthe
7、yexperiencedanesthesiainductionandtumorcrushduringoperation.However,itwaseasytocontrol.Postoperativebloodpressureremainedstable.【Conclusions】Thefullpreoperativepreparationforpa-tientswithpheochromocytomaisessentialforthesafetyandsuccessofanesthesiaandoperation.Keywor
8、ds:pheochromocytoma;α-adrenergicblocker;preoperativepreparation2000~2004年我院共收治嗜铬细胞瘤患者581.1一般资料例,手术治疗均获成功,无严重术后并发症和死亡病本组58例。男38例,女20
