术前应用α受体阻断药对腹膜后异位嗜铬细胞瘤术中血流动力学的影响

摘要

目的 探讨术前应用α受体阻断药对腹膜后异位嗜铬细胞瘤术中血流动力学的影响.方法 回顾48例经术后病理确诊为腹膜后异位嗜铬细胞瘤的患者.根据术前使用α受体阻断药(酚苄明)的情况,分为服药组(P组)和未服药组(NP组),P组为19例,NP组为29例.对其嗣术期心血管事件及术中情况进行分析.结果 术中P组HR增快大于100次/分发生率、最快HR、肿瘤切除后BP降低发生率均高于NP组(P<0.05).术中BP升高发生率及出入量差异无统汁学意义,NP组术后有2例患者转入ICU接受治疗.结论 术前使用α受体阻断药控制患者血压,并不降低腹膜后异位嗜铬细胞瘤患者术中循环剧烈波动的发生率.%Objective To evaluate the effects of α-adrenergic blockade on haemodynamic stability in ectopic pheochromocytoma patients.Methods Forty-eight cases, diagnosed as retroperitoneal ectopic pheochromocytoma by postoperative histopathology between January 2004 and April 2010, were divided into two groups depending on whether or not receiving preoperative α-adrenergic blockade with respect to perioperative cardiovascular events.Group P(n = 19) accepted α-adrenergic blockade, and group NP(n = 29)didn't accept a-adrenergic blockade Results Morbidities of increased intraoperative HR and decreased blood pressure after tumorectomy in group P are higher than those in group NP, and there are no significant differences in intraoperative hypertension morbidity and blood loss in both two groups.Two patients in group NP were submited to ICU after operation.Conclusion Preoperative preparation with α-adrenergic blockade do not affect the haemodynamic instability of the ectopic pheochromocytoma patients during operation.