甲磺酸多沙唑嗪控释片在嗜铬细胞瘤术前扩容准备中的应用

Application of doxazosin mesylate controlled release tablets in preoperative volume dilation preparation of patients with pheochromocytomas

目的探讨甲磺酸多沙唑嗪控释片在嗜铬细胞瘤术前准备中的效果。方法 67例功能性嗜铬细胞瘤患者分为甲磺酸多沙唑嗪控释片组(DOX组)36例和酚苄明组(PXB组)31例,两组患者通过口服药物准备,使血压、心率控制在正常范围及红细胞压积低于45%后进行手术。结果两组患者的年龄构成、术前最高血压、手术前血压、手术前红细胞压积具有可比性。DOX组的麻醉诱导前收缩压、麻醉稳定后收缩压及肿瘤切除后的最低收缩压均明显高于PXB组(P<0.01),DOX组的术中△SBP明显低于PXB组(P<0.01)。结论甲磺酸多沙唑嗪控释片具有与酚苄明相当的术前扩容能力,其降压效果略逊于酚苄明,但DOX组患者术中血压波动更小、更稳定,且术前准备时间明显短于PXB组。

Objective To investigate the efficacy of doxazosin mesylate controlled release tablets in preoperative preparation for pheochromocytoma patients.Methods 67 patients with functional pheochromocytomas were divided into two groups,36 in the doxazosin group（DOX） and 31 in the phenoxybenzamine group（PXB）.Medication（DOX or PXB） was used to control blood pressure,heart rate and when the HCT45% surgical removal was performed.Results There was no statistical difference in age,highest preoperative blood pressure,preoperative blood pressure and preoperative HCT.The systolic pressure before anesthesia induction and during anesthesia stable phase was significantly higher in the DOX group than in the PXB group（P0.01）.The lowest systolic pressure after surgery was also higher in the DOX group than in the PXB group（P0.01）.The intraoperative fluctuation of systolic pressure was more stable in the DOX group than in the PXB group（P0.01）.Conclusions Doxazosin appears to be an effective agent as phenoxybenzamine for the management of preoperative volume dilation for pheochromocytoma patients.Doxazosin has the effect of anti-hypertension inferior to phenoxybenzamine.The intraoperative fluctuation of systolic pressure is more stable with doxazosin preparation and the preoperative period is significantly shorter in the DOX group than in the PXB group.