异位嗜铬细胞瘤术前收缩压与术中血流动力学变化的关系  

The relationship between preoperative systolic blood pressure and intraoperative hemodynamic instability in patients with ectopic pheochromocytoma

作　　者：刘毅[1] 傅强[1] 张宏[1] 米卫东[1] 渠静[1] 

机构地区：[1]中国人民解放军总医院外科临床部麻醉手术中心,北京100853

出　　处：《徐州医学院学报》2011年第4期211-214,共4页Acta Academiae Medicinae Xuzhou

基　　金：中国人民解放军总医院苗圃基金（07MP31）致谢：[感谢徐州医学院戴体俊教授在此论文写作时给予的帮助]

摘　　要：目的 探讨腹膜后异位嗜铬细胞瘤患者术前收缩压的高低与术中血流动力学变化的关系.方法 回顾分析1990年1月-2010年7月于我院术后病理确诊为腹膜后异位嗜铬细胞瘤的85份病例,根据术前收缩压（SBP）是否大于140 mmHg,分为正常组（N组）45例和高血压组（H组）40例,将围术期心血管事件、术中用药、出入量、住院时间、术后时间、ICU收治等情况进行对比分析.结果 H组患者术中SBP大于160 mmHg的发生率、最高SBP数值、心率大于100次/min的发生率以及最快心率均明显高于N组（P〈0.05）,但肿瘤切除后2组血流动力学变化差异无统计学意义（P〉0.05）.2组住院时间、术后时间、ICU收治率差异无统计学意义（P〉0.05）.结论 腹膜后异位嗜铬细胞瘤患者术前SBP数值的高低可预测术中循环的稳定性,但并不影响患者的术后转归.Objective To investigate the relationship between elevated preoperative systolic blood pressure （SBP） and intraoperative hemodynamic instability in patients with retroperitoneal ectopic pheochromocytoma. Methods A ret-rospective analysis was conducted on the clinical data of 85 consecutive patients between January 1990 and July 2010, who were diagnosed by postoperative pathology as retroperitoneal ectopic pheochromocytoma by postoperative histopathology. Based on whether the systolic blood pressure （SBP） was greater than 140 mmHg, the patients were divided into normal preoperative group （ N group, n=45 ） and preoperative hypertension group （ H group, n = 40） and a contrastive analysis was performed on the perioperative cardiovascular events, intraoperafive medication, intra - operative output and intake, length of hospitalization, postoperative duration and ICU transfer rate, etc. Results The incidence Of intraoperarive SBP greater than 160 mmHg, highest intraoperative SBP reading, the incidence of intraoperative heart rate greater than 100 beats/min and tachyeardia morbidity in H group were significantly higher than those in N group （ P 〈 0.05 ） , while following tumorectomy, the differences in hemodynamic variations had no statistical significance between the two groups （P 〉 0.05 ）. The length of hospitalization, postoperative duration, ICU transfer rate between the two groups had no statistical difference （ P 〉 0.05 ）. Conclusion The readings of preoperative systolic blood pressure could be predictive of intraoperative hemodynamic stability but do not affect the postoperative outcomes.

关 键 词：异位嗜铬细胞瘤 腹膜后 麻醉 a受体阻滞剂 动脉收缩压 

分 类 号：R735.4[医药卫生—肿瘤]