儿童嗜铬细胞瘤和副神经节瘤切除术的麻醉管理  

Anesthesia management of children undergoing resection of pheochromocytoma and paraganglioma

作　　者：许增华 张建敏[1] 邹楠 郑铁华[1] 霍良红[1] 李立晶[1] 王芳[1] Xu Zenghua;Zhang Jianmin;Zou Nan;Zheng Tiehua;Huo Lianghong;Li Lijing;Wang Fang(Department of Anesthesiology,Beijing Children′s Hospital,Capital Medical University National Center for Children′s Health,Beijing 100045,China)

机构地区：[1]国家儿童医学中心、首都医科大学附属北京儿童医院麻醉科,北京100045

出　　处：《中华麻醉学杂志》2024年第2期209-213,共5页Chinese Journal of Anesthesiology

摘　　要：目的回顾性分析嗜铬细胞瘤和副神经节瘤(PPGL)切除术患儿的麻醉管理特点。方法回顾性收集2010年1月至2023年6月间行PPGL切除术且术后病理证实的患儿病历资料。记录术前基本信息、术中情况及术后并发症等。结果共有47例患儿病历资料进入数据分析,术中循环不稳定事件发生率为68%,术前血压降至正常水平、肿瘤最大直径≥6 cm有助于降低术中循环不稳定事件发生率(P<0.05)。术后发生低血压7例、急性左心衰1例、心律失常1例,肾上腺皮质功能不全4例,肺部感染13例。结论积极的术前准备、科学的麻醉管理和严密的术后生命体征监测可增加PPGL切除术患儿围术期安全性,减少并发症发生。Objective To retrospectively analyze the anesthetic management characteristics of children undergoing resection of pheochromocytoma and paraganglioma(PPGL).Methods The clinical data from patients undergoing resection of PPGL and confirmed histologically from January 1,2010 to June 30,2023 were retrospectively collected.The baseline characteristics,intraoperative conditions and postoperative complications were recorded.Results The clinical data from 47 pediatric patients were analyzed.The overall incidence of hemodynamic instability events was 68%(32 cases).Lowering preoperative blood pressure to normal levels and the maximum diameter of tumor≥6 cm was helpful in reducing the incidence of the intraoperative hemodynamic instability events(P<0.05).Postoperative hypotension developed in 7 cases,acute left heart failure in 1 case,arrhythmia in 1 case,adrenocortical insufficiency in 4 cases,and pulmonary infection in 13 cases.Conclusions Thorough preoperative preparation,evidence-based anesthetic management,and meticulous postoperative vital sign monitoring can increase the perioperative safety for children undergoing resection of PPGL,thereby reducing the incidence of complications.

关 键 词：嗜铬细胞瘤 副神经节瘤 儿童 麻醉 

分 类 号：R726.1[医药卫生—儿科]