硝普钠降压联合扩容用于嗜铬细胞瘤切除术  

Nitroprusside controlled hypotension and flui replacement in the operation of pheochromocytoma ectomy

作　　者：李文广[1] 刘靖[1] 毕素萍[1] 张宏[1] 

机构地区：[1]解放军总医院麻醉科,北京100853

出　　处：《军医进修学院学报》2003年第3期227-228,共2页Academic Journal of Pla Postgraduate Medical School

摘　　要：目的 :观察硝普钠控制性降压并扩容治疗对嗜铬细胞瘤切除围术期循环的影响。方法 :12例患者在切下肿瘤前用 0 0 1%硝普钠溶液经颈内静脉点滴调控血压 ,将MAP控制在 8～ 10kPa ,同时快速输入乳酸钠平衡液和代血浆各 2 0～ 30ml·kg-1·h-1扩容至尿量 10 0ml·h-1以上 ,之后根据出血量调整输液速度。监测指标 :MAP ,HR ,,尿量SpO2 。结果 :手术人均 2 10min ,硝普钠用量人均 38 333mg ,艾司洛尔 330mg ,输液总量 72 5 0ml(117ml·kg-1) ,尿量 6 10ml,SpO2 98%～ 10 0 % ,血压和心率均在理想范围 ,无任何并发症。结论Objective:To observe the effectiveness of nitroprusside controlled hypotension and fluid replacement on perioperative circulation of pheochromocytoma Methods: Before the tumor was removed,0 01% nitroprusside was used to maintain MAP within 8 and 10 kPa in 12 patients undergoing elective pheochromocytoma ectomy, Meanwhile Ringer lactic solution and succinyl gelation were infused at the rate of 20～30ml·kg -1 ·h -1 respectively, Adjust infusion rate according to bleeding and urine output after urine output was more than 100ml h -1 Monitoring: MAP, SpO 2 , ECG and urine output Results: mean operation time:210min, mean dosage of nitroprusside:38 33mg, esmolol:330mg, total infusion amount: 7250ml(117 ml·kg -1 ), Urine output:610ml, SpO2 :98%～100%, MAP and HR kept in desirable range with no operative complications Conclusions: Nitroprusside controlled hypotension combined with prompt fluid replacement contribute more stable circulation and less operative complications in the operation of Pheochromocytoma ectomy

关 键 词：硝普钠 降压 嗜铬细胞瘤 切除术 外科手术 治疗 

分 类 号：R736.6[医药卫生—肿瘤]