多沙唑嗪与酚苄明对正常血压型嗜铬细胞瘤病人术中血流动力学影响的比较  

Comparison of effects of doxazosin and phenoxybenzamine on intraoperative hemodynamics in patients with normotensive pheochromocytoma

作　　者：孔昊[1] 李楠[1] 李雪迎[2] Kong Hao;Li Nan;Li Xueying(Department of Anesthesiology and Critical Care Medicine,Peking University First Hospital,Beijing 100034,China;Biostatistics Department,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院麻醉与重症医学科,100034 [2]北京大学第一医院统计室,100034

出　　处：《中华麻醉学杂志》2020年第1期40-43,共4页Chinese Journal of Anesthesiology

摘　　要：目的比较多沙唑嗪和酚苄明对正常血压型嗜铬细胞瘤病人术中血流动力学的影响。方法收集在北京大学第一医院行手术治疗的正常血压型嗜铬细胞瘤病人的围术期资料。根据病人术前服用α受体拮抗剂的种类分为酚苄明组和多沙唑嗪组。主要观察终点为术中血流动力学的波动情况,次要观察终点包括术后循环支持、并发症和死亡情况等。结果酚苄明组24例,多沙唑嗪组37例。2组病人术中血压波动曲线下面积差异无统计学意义(P>0.05)。酚苄明组术中HR>110次/min曲线下面积大于多沙唑嗪组(P<0.05)。2组次要观察终点各指标差异无统计学意义(P>0.05)。结论正常血压型嗜铬细胞瘤病人术前服用多沙唑嗪或酚苄明对术中血压的影响无明显差异,而术前服用酚苄明病人术中心动过速发生风险较高。Objective To compare the effects of phenoxybenzamine and doxazosin on intraoperative hemodynamics in patients with normotensive pheochromocytoma.Methods Perioperative data of patients who underwent surgery for normotensive pheochromocytoma in Peking University First Hospital from January 1,2004 to December 31,2017 were collected.Patients were divided into phenoxybenzamine group and doxazosin group according to the type of preoperativeα-blockade.The primary endpoint was intraoperative hemodynamic fluctuations.Secondary endpoints included postoperative circulatory support,complications,mortality,and etc.Results Sixty-one patients were included in the study,with 24 cases in phenoxybenzamine group and 37 cases in doxazosin group.There was no significant difference in the area under the curve of intraoperative blood pressure fluctuation between the two groups(P>0.05).The area under the curve of intraoperative heart rate>110 bpm was significantly greater in phenoxybenzamine group than in doxazosin group(P<0.05).There was no significant difference in the secondary endpoints between the two groups(P>0.05).Conclusion The effect of preoperative administration of doxazosin or phenoxybenzamine on blood pressure fluctuation has no significantly statistical difference in patients with normotensive pheochromocytoma,and the patients took phenoxybenzamine preoperatively have an increased risk of intraoperative tachycardia.

关 键 词：多沙唑嗪 酚苄明 嗜铬细胞瘤 血流动力学 

分 类 号：R735[医药卫生—肿瘤] R614[医药卫生—临床医学]