腹膜后腹腔镜肾上腺嗜铬细胞瘤切除术与开放手术患者血压变化的对比研究  

A comparative study on the change of blood pressure between retroperitoneoscopic adrenalectomy and conventional surgery for adrenal pheochromocytoma

作　　者：赵林飞[1] 邱瑞香[2] 张翠莲[3] 刘鲁东[3] 

机构地区：[1]潍坊医学院泌尿外科教研室,山东潍坊261042 [2]潍坊医学院公共卫生学院流行病与卫生统计教研室 [3]潍坊市人民医院

出　　处：《腹腔镜外科杂志》2011年第4期308-310,共3页Journal of Laparoscopic Surgery

摘　　要：目的:对比分析腹膜后腹腔镜与开放肾上腺嗜铬细胞瘤切除术中患者血压的变化,评价腹膜后腹腔镜手术切除肾上腺嗜铬细胞瘤的安全价值。方法:回顾性分析2008年9月至2011年2月为26例患者行单侧腹膜后腹腔镜肾上腺嗜铬细胞瘤手术(腹腔镜组)和19例单侧开放性肾上腺嗜铬细胞瘤手术(开放组)的临床资料,对比两组患者术中血压的变化(术前血压、术中血压波动幅度、术中高血压持续时间、手术时间、心率)。结果:所有手术均获成功,术中未发生明显并发症,腹腔镜组与开放组肿瘤最大径分别为(4.42±0.79)cm、(4.87±0.19)cm(t=-1.84,P=0.73);手术时间分别为(66.85±19.52)min、(116.79±14.62)min(t=-9.383,P=0.00);术中收缩压波动幅度分别为[9.5(2～34)]mm Hg、[18(12～40)]mm Hg(u=99.50,P=0.001);术中血压增高持续时间为[39.5(17～59)]min和[83(66～113)]min(u=0.000,P=0.00),手术持续时间分别(66.85±8.75)min、(116.78±14.62)min(t=-9.38,P=0.00)。结论:腹膜后腹腔镜肾上腺嗜铬细胞瘤切除术术中对血压的控制均要优于传统开放手术。Objective：To compare the changing of blood pressure between retroperitoneoscopic adrenalectomy and conventional surgery,and evaluate the safe value of retroperitoneoscopic surgery in treating adrenal pheochromocytoma.Methods：Retrospective analysis was made on the clinical data of 26 cases underwent unilateral retroperitoneoscopic adrenalectomy（laparoscopic group） and 19 cases underwent conventional adrenalectomy（conventional group） from Sep.2008 to Feb.2011.The differences between the two groups were studied focusing on the blood pressure changing（the blood pressure before operation,blood pressure fluctuations during the operation,the time which high blood pressure continued during the operation,the operating time and heart rate）.Results：All the operations were successful without obvious complications,and the mean largest dimension of the tumor was（4.42±0.79）cm in laparoscopic group vs.（4.87±0.19）cm in conventional group（P0.05）.The mean operative time was（66.85±19.52）min in laparoscopic group vs.（116.79±14.62）min in conventional group（P0.01）.The blood pressure fluctuations was 9.5（2-34）mm Hg in laparoscopic group,18（12-40）mm Hg in surgery group.The time which high blood pressure continued was 39.5（17-59）min in laparoscopic group,83（66-113）min in conventional group.The operation time was（66.85±8.75）min in laparoscopic group vs.（116.78±14.62）min in conventional group.Conclusions：Retroperitoneoscopic surgery for adrenal pheochromocytoma in controlling the blood pressures has much more advantages than conventional surgery.

关 键 词：嗜铬细胞瘤 肾上腺切除术 腹腔镜检查 腹膜后途径 

分 类 号：R736.6[医药卫生—肿瘤]