嗜铬细胞瘤和副神经节瘤术前超声心动图参数与术中血流动力学波动的相关性分析  

Correlation Analysis of Preoperative Echocardiographic Parameters and Intraoperative Hemodynamic Fluctuations in Pheochromocytoma and Paraganglioma

作　　者：王春燕[1] 范芳芳[1] 于扬[1] 杨颖[1] Wang Chunyan;Fan Fangfang;Yu Yang;Yang Ying(Institute of Cardiovascular Disease,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院心血管疾病研究所,北京市100034

出　　处：《中国超声医学杂志》2022年第2期169-172,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的分析行外科手术治疗的嗜铬细胞瘤和副神经节瘤(PPGL)患者,术前超声心动图参数与术中血流动力学波动之间的相关性。方法入选患者108例,回顾性记录和分析患者肿瘤特点、术前超声心动图参数、术中血流动力学情况等资料。结果①术前左室射血分数与舒张功能情况,与术中血流动力学波动无相关性。②术中使用血管活性药物种类≥3种的患者中,术前e′<7 cm/s的患者比例更高。术前TRmax在术中DBP波动有统计学意义,术前e′异常的患者术中心率波动有统计学差异。③e′异常与术中心率波动范围呈正相关。结论PPGL术前超声心动图左室整体收缩、舒张功能指标与术中血流动力学波动无相关性,但e′异常与术中血流动力学波动相关,提示术前超声心动图评估除左室功能外,应更多关注超声参数。Objective To analyze the correlation between preoperative echocardiographic parameters and intraoperative hemodynamic fluctuations in patients with pheochromocytoma and paraganglioma(PPGL)undergoing surgical treatment.Methods 108 patients were enrolled,and the tumor characteristics,preoperative echocardiographic parameters,intraoperative hemodynamics and other data were recorded and analyzed.Results①The left ventricular ejection fraction and diastolic function before operation had no correlation with intraoperative hemodynamic fluctuations.②Among patients who used≥3 types of vasoactive drugs during surgery,the proportion of patients with e′<7 cm/s before surgery was higher.There were statistically significant differences in the intraoperative DBP fluctuations of TRmax before surgery,and the intraoperative heart rate fluctuations of patients with preoperative e′abnormalities were statistically different.③The abnormality of e′was positively correlated with the fluctuation range of the surgical center rate.Conclusions Preoperative echocardiography of PPGL has no correlation between overall left ventricular systolic and diastolic function indicators and intraoperative hemodynamic fluctuations,but e′abnormality is related to intraoperative hemodynamic fluctuations,suggesting that preoperative echocardiographic evaluation not only requires attention for left ventricular function,more attention should be paid to ultrasound parameters.

关 键 词：超声心动图 嗜铬细胞瘤 副神经节瘤 血流动力学 左室收缩功能 左室舒张功能 

分 类 号：R540.45[医药卫生—心血管疾病] R739.4[医药卫生—内科学]