肾上腺嗜铬细胞瘤切除手术中应用硫酸镁对血儿茶酚胺与皮质醇的影响

Effects of MgSO 4 on the Plasma Catecholamine and Cortisol during Adrenal Pheochromocytoma Operation

目的：探讨在嗜铬细胞瘤手术中应用硫酸镁的价值。方法：肾上腺嗜铬细胞瘤病人６例。麻醉诱导前静注硫酸镁１．２５～２．５ｇ，继以２．５％硫酸镁静脉连续滴注至肿瘤切除。检测不同时点血儿茶酚胺、皮质醇、电解质和循环指标的变化。结果：血儿茶酚胺在肿瘤切除前变化无显著差异，切除后降低，但无统计学意义；血皮质醇无显著变化；循环指标平稳，气管插管、腹腔探查、分离肿瘤时均无内源性儿茶酚胺升高所致的循环指标的变化。结论：肾上腺嗜铬细胞瘤手术应用硫酸镁控制急性高血压反应，是一安全有效的措施。

Objective: The effect of MgSO 4 on plasma catecholamine and cortisol was studied during operation in patients with adrenal pheochromocytoma.Methods:6 adult patients with adrenal pheochromocytoma, were operated under fentanyl pancuronium enflurane anesthesia. MgSO 4 (MS) in abolus of 25～50mg/kg was given intravenously and 2 5% MgSO 4 was infused until the removal of the tumor. The plasma CA, COS, Mg 2+ ,Ca 2+ ,K + were measured and hemodynamics (MAP,CVP,HR) and ECG were monitorred in A (before induction), B (after intubation), C(during abdominal exploration) and D(after toma resection). Results:After the tumor remoral plasma catecholamine and cortisol were not changed significantly in comparison with that before. No significant circulatory change was found during procedures on the tumor. Conclusion: MS is valuable during operation of adrenal phrochromocytoma.