术前多沙唑嗪控制血压对嗜铬细胞瘤切除术中血流动力学及术后并发症的影响  

Effect of preoperative blood pressure control with doxazosin on intraoperative hemodynamics and postoperative complications in pheochromocytoma resection

作　　者：游凯[1,2] 李强 罗艳[1] YOU Kai;LI Qiang;LUO Yan(Department of Anesthesiology,Ruijin Hospital Affiliated To Shanghai Jiao Tong University School of Medicine, Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院麻醉科,200025 [2]南昌大学第一附属医院麻醉科

出　　处：《临床麻醉学杂志》2018年第12期1193-1197,共5页Journal of Clinical Anesthesiology

摘　　要：目的分析多沙唑嗪准备下术前血压控制水平对嗜铬细胞瘤切除术中血流动力学及术后并发症的影响。方法选择2014年10月至2017年9月择期行嗜铬细胞瘤切除术且术后病理证实为嗜铬细胞瘤的患者,所有患者均术前口服多沙唑嗪至少2周控制血压。收集患者一般情况、肿瘤特点、术中麻醉管理及血流动力学指标、术后情况等资料。将术前SBP<160mmHg且DBP<90mmHg定义为血压控制良好,否则为血压控制欠佳。记录术中血流动力学及术后并发症等指标。结果共纳入146例患者,其中115例(78.8%)血压控制良好。校正混杂因素后显示血压控制欠佳组和血压控制良好组血流动力学指标及术后并发症发生率差异无统计学意义。结论对于术前进行充分多沙唑嗪准备的择期嗜铬细胞瘤切除患者,即使术前血压控制欠佳,在完善的麻醉管理下术中血流动力学波动及术后并发症的风险并无显著增加。Objective To figure out the effect of preoperative blood pressure control with doxazosin on intraoperative hemodynamics and postoperative complications in pheochromocytomaressection.Methods Patients who underwent elective resection of pheochromocytoma confirmed by pathology from October 2014 to September 2017 in Ruijin Hospital were included in our study.All patients took doxazosin for at least two weeks before surgery.Data including characteristics of patients and tumor,intraoperative anesthesia management and hemodynamic indicators,and post operative conditions were collected.Well blood pressure control was defined as preoperative blood pressure<160/90 mmHg.The effect of preoperative blood pressure control on intraoperative hemodynamics and postoperative complications in pheochromocytoma resection were analyzed.Results In total,146 patients were included,with 115(78.8%)patients in well blood pressure control group.No significant differences in intraoperative hemodynamic indicators and postoperative complications between the well blood pressure control group and the poor blood pressure control group were found after adjusting multiple confounding factors.Conclusion For the patients undergoing elective pheochromocytoma resection who have been adequately prepared with doxazosin,poor preoperative blood pressure control doesn't significantly increase the risk of intraoperative hemodynamic fluctuations and postoperative complications under sound anesthesia management.

关 键 词：嗜铬细胞瘤 血流动力学 并发症 

分 类 号：R614[医药卫生—麻醉学] R736.6[医药卫生—外科学]