嗜铬细胞瘤的围手术期处理

The perioperative management of pheochromocytoma

嗜铬细胞瘤是嗜铬细胞起源的分泌儿茶酚胺的肿瘤。典型患者表现为阵发性高血压伴有"头痛、心悸、出汗"三联症,亦可出现致命的心、脑、肾血管损害,尤其在麻醉诱导及手术时。术前合理地使用α受体阻滞剂、术中积极补充有效血容量是手术成功的关键因素,术后完善复查及随访工作,使患者及家属获益。

Summary：Pheochromocytomas are tumors of neuroectodermal origin arising from chromaffin cells. Patients with pheochromocytoma typically present with paroxysmal episodes or spells that include the classic triad of severe headaches, palpitations, and diaphoresis. Patients may also present with lethal cardinal, cerebral and renal damage, especially during anaesthesia and operation. Careful perioperative management with alpha-adrenergic blockade and proper volume expansion are keys for good outcome of operation. Patients may benefit from long-term follow-up.