嗜铬细胞瘤危象的临床类型及处理

Pheochromocytoma crisis: clinical classification and management

报道PHEO 7例11例次危象类型及处理.共分五种危象类型,术前以高血压危象为多见,高血压与低血压快速交替型危象及心电图出现短暂急性心肌梗塞图形的心脏危象等少见。术中高血压-心脏危象2例,迫使中止手术。术后低血压危象2例,术前高血压危象1例,用酚妥拉明难以控制,改用静滴酚苄明治疗,效果满意;1例肾上腺肿瘤术后低血压危象,用β受体兴奋剂抢救成功。认为:静脉应用酚苄明抢救PHEO危象优于酚妥拉明,术前充分准备、选择合理麻醉、接触肿瘤时动作轻柔是预防PHEO危象的重要环节。

This paper reports the management of 11 crisis events in 7 patients with pheochromocytoma. 7 crises occurred preoperatively and presented as episode of hypertension, alternate episode of hypertension and hypotension, and acute transient cardiac infarction on ECG. Paroxysmalattack of hypertension and severe arrhythmia occurred intraoperatively in two patients resulting in pause of operation 2 crises occurred postoperatively, including episode of hypertension which was controlled successfully with intravenous infusion of phenoxybenzamine after failing regitine administracion and hypotension which was managed with β-receptor stimulant.